Neurologic infections in a Nigerian university teaching hospital

Neurologic infections are an important cause of morbidity and mortality especially worldwide but much more in the African continent. The frequency of the different types of neurologic infections and their mortality in this part of Nigeria is not known.

To review cases admitted into the main tertiary referral center in Rivers State of Nigeria with neurologic infections over a 10-year period and to determine the types of infections, their frequency and the mortality.

Case notes of all admissions into the medical wards of UPTH, Port Harcourt between April 1993 and March 2003 were reviewed. Cases admitted with neurologic infections were extracted and analyzed for the study.

Of the 1,395 patients admitted with neurologic disorders during the study period, 311 (22.3%) had neurological infections. The M:F ratio and mean age of patients with neurologic infections were 1.7:1 and 34.1 years respectively. The most common infections identified were meningitis 136(43.7%), tetanus 90(28.9%), Pott's disease with cord compression 30(9.6%), viral meningoencephalitis 27(8.7%) and tuberculous meningitis (TBM) 19(6.1%). The case fatality was high: meningitis 49.3%, tetanus 47.8%, Pott's disease 23.3%, meningoencephalitis 44.4% and TBM 68.4%.

Preventable neurologic infections are a very important cause of morbidity and mortality in this environment. Cases presenting with suspicious neurologic infections should be referred to centers where specialized care can be instituted.