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Recurrent pyogenic meningitis--a retrospective study.

S Maitra1, S K Ghosh

  • 1General Hospital, Middlesbrough, Cleveland.

The Quarterly Journal of Medicine
|October 1, 1989
PubMed
Summary
This summary is machine-generated.

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Recurrent pyogenic meningitis in 17 patients was linked to intracranial abnormalities or complement deficiencies. Prompt antibiotic treatment proved effective, but prophylaxis is key for prevention in some cases.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Recurrent pyogenic meningitis poses significant clinical challenges.
  • Identifying underlying causes is crucial for effective management and prevention.
  • Previous studies have highlighted various risk factors, including trauma and anatomical defects.

Purpose of the Study:

  • To analyze the causes, clinical features, and outcomes of recurrent pyogenic meningitis.
  • To evaluate the effectiveness of conventional antibiotic treatment and explore preventive strategies.
  • To investigate the role of intracranial abnormalities and complement deficiencies in recurrent meningitis.

Main Methods:

  • Retrospective analysis of 17 patients with two or more episodes of pyogenic meningitis from eight UK centers.

Related Experiment Videos

  • Review of medical records, including history of head injury, cerebrospinal fluid analysis, and radiological investigations.
  • Assessment of underlying pathologies such as intracranial abnormalities, cerebrospinal fluid leaks, and primary complement deficiencies.

    • Main Results:

    • Thirteen patients had intracranial abnormalities, with seven experiencing head injuries and five with cerebrospinal fluid rhinorrhoea.
    • Pneumococci were the most common pathogen (25 episodes), followed by Neisseria meningitidis in patients with complement deficiencies (10-11 episodes).
    • All 58 meningitis episodes responded to antibiotics without mortality, though surgical interventions had variable success.

    Conclusions:

    • Recurrent pyogenic meningitis is often associated with identifiable intracranial abnormalities or complement deficiencies.
    • Conventional antibiotic therapy is highly effective, but antimicrobial prophylaxis may be necessary for prevention in select patients.
    • Advanced imaging like radioactive cisternography can aid in diagnosing cerebrospinal fluid leaks, while complement deficiency correction is not currently feasible.