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Causes and presentation of meningitis in a Baltimore community hospital 1997-2006

Kjell Wiberg1, Anitra Birnbaum, Jeremy Gradon

  • 1Johns Hopkins University/Sinai Hospital program in Internal Medicine, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.

Southern Medical Journal
|September 16, 2008
PubMed
Abstract

Insights

Community-acquired meningitis in adults is diverse, with varied causes and symptoms. The classic triad of fever, neck stiffness, and altered mental status is uncommon, even in bacterial meningitis cases.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Clinical Medicine

Background:

  • Community-acquired meningitis presents a significant public health challenge in adult populations.
  • Understanding the diverse etiologies and clinical presentations is crucial for timely diagnosis and effective management.

Purpose of the Study:

  • To describe the clinical presentation and etiological factors of community-acquired meningitis in adult patients.
  • To analyze demographic data, symptoms, cerebrospinal fluid findings, and patient outcomes.

Main Methods:

  • A retrospective chart review was conducted.
  • Data were collected from adult patients diagnosed with meningitis between 1997 and 2006.
  • Information gathered included patient demographics, presenting symptoms, cerebrospinal fluid analysis, and treatment outcomes.

Main Results:

  • Eighty patients were identified with meningitis: 17 bacterial, 18 viral, 39 aseptic (unclear etiology), and 6 noninfectious causes.
  • Streptococcus pneumoniae was the most frequent bacterial pathogen.
  • Herpes simplex virus, enteroviruses, and West Nile encephalitis virus were common viral causes.
  • The classic meningitis triad (fever, neck stiffness, altered mental status) was observed in only 5% of all patients and 21.4% of bacterial meningitis cases.

Conclusions:

  • Meningitis should be suspected in patients with any central nervous system complaints, irrespective of the presence of the classic triad.
  • The study highlights the variability in clinical presentation, emphasizing the need for a broad differential diagnosis.

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