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[Prognostic factors in bacterial meningitis in adults. Retrospective analysis of 46 patients]
Abstract:
Clinical and laboratory data on 46 patients with acute bacterial meningitis were analyzed in a retrospective survey. The incidence of bacterial meningitis in hospital admissions was 1.3% and the mortality 33%. Streptococcus pneumoniae was the most frequent etiologic agent. Mortality was highest for pneumococcal meningitis and was higher in patients over 50 years of age (83% vs 25%, p less than 0.05). The initial stage of consciousness was prognostically important. All awake patients survived, while the more impaired the consciousness (from lethargy to coma), the higher the mortality (19%, 25%, and 78% respectively). Seizures and paresis of the third cranial nerve were significantly higher in lethal cases. Brain edema was the leading cause of death (60%). The interval between hospital admission and start of antibiotic treatment was crucial for prognosis. Patients who received the first dose of antibiotics within 3 hours after admission had a mortality of 13%, while a delay of 6-24 hours increased the mortality to 3/3.
Insights
Acute bacterial meningitis has a 33% mortality rate, with Streptococcus pneumoniae being the most common cause. Early antibiotic treatment within 3 hours significantly improves survival rates.
Area of Science:
- Infectious Diseases
- Neurology
- Critical Care Medicine
Background:
- Bacterial meningitis remains a significant cause of mortality and morbidity worldwide.
- Streptococcus pneumoniae is a leading pathogen in acute bacterial meningitis.
- Understanding prognostic factors is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze clinical and laboratory data of patients with acute bacterial meningitis.
- To identify key factors influencing mortality in bacterial meningitis.
- To evaluate the impact of treatment timing on patient survival.
Main Methods:
- Retrospective analysis of clinical and laboratory data from 46 patients.
- Statistical analysis to determine the significance of various factors.
- Review of patient records for demographic, clinical, and treatment details.
Main Results:
- Overall mortality for bacterial meningitis was 33%.
- Streptococcus pneumoniae was the most frequent cause, with highest mortality.
- Mortality increased significantly in patients over 50 years and those with impaired consciousness.
- Brain edema was the primary cause of death (60%).
- Timely antibiotic administration within 3 hours of admission reduced mortality to 13%.
Conclusions:
- Age, consciousness level, and specific clinical signs like seizures and third cranial nerve paresis are critical prognostic indicators.
- Prompt initiation of antibiotic therapy is paramount for reducing mortality in acute bacterial meningitis.
- Brain edema is a major determinant of fatality, highlighting the need for effective management strategies.