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Related Experiment Videos

Meningococcal meningitis with 'normal' cerebrospinal fluid

M T Coll1, M S Uriz, V Pineda

  • 1Hospital General de Granollers, Barcelona, Spain.

The Journal of Infection
|November 1, 1994
PubMed
Summary

Meningococcal meningitis can present without cerebrospinal fluid (CSF) abnormalities. This study found that patients with normal CSF counts and fever/rash had similar outcomes to those with elevated CSF counts, highlighting a diagnostic challenge.

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Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Meningococcal meningitis is a serious infection, typically characterized by cerebrospinal fluid (CSF) abnormalities.
  • Early diagnosis and treatment are crucial for favorable outcomes.

Purpose of the Study:

  • To investigate cases of meningococcal meningitis presenting with normal CSF counts.
  • To compare clinical features and outcomes of patients with and without CSF abnormalities.

Main Methods:

  • Prospective study of patients diagnosed with Neisseria meningitidis infection.
  • Analysis of clinical data including CSF analysis, symptoms, and outcomes.
  • Comparison of patient groups based on CSF pleocytosis.

Main Results:

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  • Eight out of 82 patients with meningococcal meningitis had normal initial CSF counts.
  • Patients without CSF abnormalities showed similar fever duration, rash, leukopenia, and fatality rates compared to those with pleocytosis.
  • Group B Neisseria meningitidis was the most common isolate, with some cases showing reduced penicillin susceptibility.

Conclusions:

  • Meningococcal meningitis can manifest without typical CSF pleocytosis, posing diagnostic challenges.
  • Clinical presentation (fever, rash) and outcomes are not significantly different between patients with and without CSF abnormalities.
  • Prompt recognition of meningococcal disease is vital, even with unremarkable initial CSF findings.