[Catarrhal prodromes and pharyngotonsillar hyperemia in acute bacterial meningitis]

In the pathogenesis of acute bacterial meningitis (ABM), the direct entry of the responsible microorganism at the level of the upper respiratory tract is considered as one of the most important etiopathogenic mechanisms, occasionally presenting catarrhal symptoms in the initial stages of the disease. It appears that upper respiratory tract infections favor the penetrability of certain bacteria, such as N. meningitidis and S. pneumoniae, which constitute the most frequent causes of ABM in our medium. The rhinopharynx is the most usual entry point. The present study was designed to ascertain the frequency of these prodromic signs and symptoms in ABM. The presence of this catarrhal semiology in the days prior to hospital admission was analyzed, in addition to the existence of pharyngotonsillar hyperemia (FTH) at the moment of admission of 250 cases of community-acquired ABM. We believe that these data are of clinical interest, and were not found in the reviewed series.