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[Spontaneous meningitis caused by gram-negative bacilli]
M Cuenca1, R de Andrés, M de Górgolas
1Departamento de Microbiología Clínica, Fundación Jiménez Díaz, Madrid.
Revista Clinica Espanola
|December 31, 1997
Summary
Spontaneous meningitis caused by Gram-negative rods is rare, primarily affecting older, immunosuppressed individuals or those with urinary tract issues. Early diagnosis via cerebrospinal fluid analysis and treatment with third-generation cephalosporins improve outcomes.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Context:
- Spontaneous meningitis caused by Gram-negative bacilli is an uncommon yet serious infection.
- This study examines cases from 1973-1995 to understand its epidemiology and outcomes.
Purpose:
- To analyze causative factors, clinical and microbiological characteristics, and prognosis of spontaneous Gram-negative bacillary meningitis in adults.
- To identify risk factors associated with mortality and evaluate diagnostic methods and therapeutic impacts.
Summary:
- The study reviewed 20 cases of Gram-negative meningitis, predominantly in patients over 65, with underlying conditions, or urinary tract abnormalities.
- Extranosocomial origin was common, with E. coli being the most frequent pathogen. Decreased consciousness, fever, and neck stiffness were key symptoms.
- Cerebrospinal fluid analysis was crucial for diagnosis. Immunosuppression, septic shock, and suboptimal antimicrobial therapy were linked to mortality.
Impact:
- Highlights the importance of cerebrospinal fluid examination for diagnosing Gram-negative meningitis.
- Suggests that third-generation cephalosporins have significantly improved the prognosis of this infection.
- Identifies key risk factors for mortality, aiding in clinical decision-making and patient management.