Retrospective Evaluation of Two Hundred and Four Bacterial Meningitis Cases

Abstract

Objective: We aimed to retrospectively evaluate our cases followed up in department of Infectious Diseases, Medical Faculty of Yuzuncu Yil University with the diagnosis of bacterial meningitis between January 1995 and August 2008 in view of their clinical and laboratory findings. Material and Methods: Demographic features, history, physical examination and laboratory findings were achieved by screening the files. The diagnosis of bacterial meningitis in cases clinically consistent with suspected meningitis was done by microbiological, biochemical and serological tests performed on cerebrospinal fluid (CSF) samples, by radiological examinations of central nervous system (CNS) and the answers of the patients to antibacterial treatment. Results: Of 204 patients, 96 were females and 108 were males with an average age of 30.8 +/- 13.9 years. Thirty three percent of cases had acute bacterial meningitis (ABM), 44% had tuberculous meningitis (TM) and 23% brucella meningitis (BrM). Headache was the most frequent symptom in all cases with 80%, being 89.5% in ABM cases, 71% in TM cases and 74.5% in BrM cases. In CSF cultures of the patients with ABM, S. pneumonia was isolated in 13.4% of the cases, N.meningitides in 7.5% and S.aures in 3%. In patients with TM, acid-fast bacilli was seen in 20% of the cases. B. melitensis was grown from CSF in 10.6% of the patients with BrM and from blood in 17.2% of the patients. Mortality rate was 13.4% in ABM cases, 14.4% in TM cases and 2.1% in BrM cases. Conclusion: TM seems to be more frequent in our region when compared to other causes of bacterial meningitis and its high morbidity and mortality rates attract the attention. Clinical and laboratory findings of BrM are vaguer than other forms of bacterial meningitis.