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A study on the clinical outcomes and management of meningitis at a tertiary care centre
Aparna Yerramilli1, Priya Mangapati1, Subhashini Prabhakar2
1Department of Pharmacy Practice, Sri Venkateshwara College of Pharmacy, Madhapur, India.
Background:
Meningitis is a life threatening central nervous system infection that is prevalent worldwide. Many studies have been conducted on bacterial meningitis, but the information is inadequate on the other types of meningitis, especially prevalent in India. Regional information regarding trends, in terms of etiology and microbiological susceptibility, are essential for timely and adequate management of meningitis.
Aims:
The present study was undertaken to evaluate the changing epidemiology of meningitis by reviewing the causative agents, the available laboratory methods for making the etiological diagnosis, the risk factors and the clinical outcomes, and the management of meningitis in our patient population.
Materials And Methods:
It is an observational study conducted at a tertiary care centre. A structured data form was designed to collect the information from the medical records and charts of medical investigations of the patients. Details regarding etiological agents, prevalence of clinical features and management were recorded and interpreted.
Results:
A total of 147 patients suspected to be having meningitis were included. The common types of meningitis in our study were aseptic (39%), tuberculous (28%), pyogenic (28%), fungal (3%) and others (2%). The classical triad of headache with fever, neck stiffness, and altered mental sensorium was seen in 26% patients, and 83% had at least 2 out of these 4 symptoms. The incidence of seizures was found to be 63% in the presence of aseptic meningitis. Significant clinical improvement was seen in 89% of the patients suffering from aseptic meningitis.
Conclusions:
Aseptic meningitis was found to be the predominant type among all different varieties of meningitis. An increased incidence of meningitis was seen in patients with diabetes mellitus. The incidence of seizures was high in viral/aseptic meningitis. The empirical treatment given in most of the cases was ceftriaxone. Isolation of the culpable organisms was possible in a very few cases due to the usage of empirical antibiotics prior to the performance of the lumbar puncture for the diagnostic analysis of the cerebrospinal fluid.
Insights
Aseptic meningitis is the most common type, particularly in India. This study highlights its prevalence, associated seizures, and improved outcomes, emphasizing the need for better etiological diagnosis despite empirical antibiotic use.
Area of Science:
- Neurology
- Infectious Diseases
- Epidemiology
Background:
- Meningitis is a critical global CNS infection with limited data on non-bacterial types in India.
- Understanding regional etiological trends and antimicrobial susceptibility is vital for effective meningitis management.
Purpose of the Study:
- To analyze the evolving epidemiology of meningitis, including causative agents, diagnostic methods, risk factors, clinical outcomes, and management strategies.
- To provide regional insights into meningitis trends in India.
Main Methods:
- An observational study was conducted at a tertiary care center.
- Data was collected from patient medical records using a structured data form.
- Etiological agents, clinical features, and management details were recorded and analyzed.
Main Results:
- Aseptic meningitis (39%) was the predominant type, followed by tuberculous (28%) and pyogenic (28%).
- The classical meningitis triad was present in 26% of patients; 83% had at least two symptoms.
- Seizures occurred in 63% of aseptic meningitis cases, with 89% showing significant clinical improvement.
Conclusions:
- Aseptic meningitis is the most common form, with increased incidence in diabetic patients.
- High seizure incidence is noted in viral/aseptic meningitis.
- Empirical ceftriaxone was common, limiting organism isolation due to pre-lumbar puncture antibiotic use.
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