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Meningitis admitted to a military hospital: a retrospective case series

Travis Harrell1, John S Hammes

  • 1Division of General Internal Medicine, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889, USA.

Military Medicine
|November 2, 2012
PubMed

Insights

Meningitis is a common diagnosis, but severe bacterial causes are rare in military adults. Most cases are aseptic, with few serious outcomes, indicating a generally good prognosis.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Epidemiology

Background:

  • Meningitis is a frequent reason for hospital admission.
  • Recent descriptive studies on meningitis, particularly within the U.S. Military Health System, are lacking.
  • Understanding current meningitis epidemiology and outcomes is crucial for public health.

Purpose of the Study:

  • To describe the rates, characteristics, and outcomes of meningitis in adult patients at a U.S. military medical center.
  • To compare bacterial and aseptic meningitis cases.
  • To identify common pathogens and risk factors.

Main Methods:

  • Retrospective chart review of adult patients admitted with meningitis from January 2004 to December 2008.
  • Exclusion criteria included non-compliance with case definition, missing data, nosocomial, or iatrogenic meningitis.
  • Analysis of cerebrospinal fluid (CSF) cultures, polymerase chain reaction (PCR) testing, and serological results.

Main Results:

  • 221 cases met the criteria; 208 (94.1%) were aseptic meningitis.
  • Enteroviruses and herpes simplex viruses were identified in 20.2% and 8.2% of cases via CSF PCR, respectively.
  • Identified bacterial pathogens included Neisseria meningitidis and Streptococcus pneumoniae (3 cases each).
  • Only three patients experienced poor outcomes: one death from S. pneumoniae and two with long-term neurologic deficits.

Conclusions:

  • Meningitis is a common admission diagnosis, but serious bacterial infections are infrequent.
  • Aseptic meningitis is the predominant form, with viral causes being most common.
  • Adverse outcomes and mortality associated with meningitis in this military population are rare.

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