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Bacterial Meningitis in the Elderly: An 8-Year Review of Cases in a University Hospital

de O Papaiordanou PM1, Cadogan, Ribeiro Resende M

  • 1Infectious Diseases Division, University of Campinas - UNICAMP, São Paulo.

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
|November 30, 2000
PubMed

Insights

Bacterial meningitis in older adults often presents with subtle symptoms and unusual pathogens, leading to high mortality. Early suspicion and prompt treatment are crucial for improving outcomes in this vulnerable population.

Area of Science:

  • Geriatrics
  • Infectious Diseases
  • Neurology

Background:

  • Bacterial meningitis poses a significant threat to older adults.
  • Clinical presentation and causative agents in this demographic can differ from younger populations.

Purpose of the Study:

  • To evaluate clinical and laboratory characteristics of bacterial meningitis in individuals over 59 years old.
  • To identify variables associated with prognosis in elderly patients with meningitis.

Main Methods:

  • Retrospective analysis of 64 episodes of bacterial meningitis in patients over 59 years old.
  • Evaluation of clinical symptoms, laboratory findings, causative microorganisms, and outcomes.

Main Results:

  • High mortality rate (51.5%) observed.
  • Common symptoms included fever, psychomotor agitation, stupor, or coma; classic signs like headache and neck rigidity were often absent.
  • Associated conditions like diabetes mellitus and pneumonia were frequent.
  • Poor prognosis linked to specific pathogens (L. monocytogenes, Gram-negative bacilli, S. pneumoniae) and factors such as coma and immunocompromised status.

Conclusions:

  • Elderly patients with meningitis may present with atypical symptoms, including altered mental status.
  • Unusual microorganisms can be causative agents.
  • Prompt diagnosis and treatment are essential due to high mortality and poor prognosis, even with intensive care.

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