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Acute bacterial meningitis: an analysis of factors influencing prognosis

G R Hodges, R L Perkins

    The American Journal of the Medical Sciences
    |November 1, 1975
    PubMed

    Insights

    Older age, pre-existing conditions, and neurological impairment are key indicators of poor prognosis in acute bacterial meningitis. Early detection and treatment are crucial for improving patient outcomes in these critical cases.

    Area of Science:

    • Neurology
    • Infectious Diseases
    • Clinical Medicine

    Background:

    • Acute bacterial meningitis is a severe infection with potentially devastating outcomes.
    • Identifying prognostic factors is crucial for effective patient management and resource allocation.

    Purpose of the Study:

    • To analyze historical, physical, and laboratory findings for prognostic significance in acute bacterial meningitis.
    • To identify predictors of poor outcomes in patients treated for bacterial meningitis.

    Main Methods:

    • Retrospective review of 349 cases of acute bacterial meningitis treated between 1949 and 1973.
    • Analysis of initial patient data including demographics, clinical presentation, and laboratory results.

    Main Results:

    • Poor prognosis associated with age ≥40 years, predisposing/associated illnesses, absent nuchal rigidity, and cerebral dysfunction.
    • Elevated cerebrospinal fluid (CSF) protein, positive CSF smear/culture, and bacteremia correlated with poor outcomes.
    • Factors like race, sex, prior antibiotics, and CSF glucose levels did not show prognostic significance.

    Conclusions:

    • Age, comorbid conditions, and neurological status are significant predictors of prognosis in bacterial meningitis.
    • Cerebrospinal fluid analysis (protein, smear, culture) and bacteremia provide valuable prognostic information.
    • Certain factors, including age, influence the impact of other prognostic indicators like cerebral dysfunction.

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