Acute Meningitis in Mansoura Fever Hospital

Abstract

Background: Meningitis is a serious health problem that results in grave morbidity and mortality. It is caused by several organisms and present with various presenting pictures imparting some challenge. Aim: Highlighting the etiology and prognosis of acute meningitis in Mansoura Fever Hospital. Subjects and Methods: A prospective cross sectional observational study. The study included 350 cases admitted with suspected meningitis. Lumbar puncture: for collection of cerebrospinal fluid (CSF) samples. CSF analysis, microbiological examination of CSF, and blood culture and antibiotic sensitivity test were done. Brain magnetic resonant imaging (MRI) was performed before lumbar puncture in some patients. Detailed analysis of epidemiologic characteristics, clinical data and laboratory findings, the causative organisms, prognosis of all the patients with acute bacterial meningitis (ABM) were studied. Results: Meningitis occurred at all age groups. A significant proportion of meningitis patients (60%) reported a positive history of antibiotic intake in the few days (3-5) before admission to the hospital. 79.1% of ABM patients had a CSF leukocyte count in the range of > 100 up to 1,000 cell/mm3 and 80% had CSF neutrophil percentage > 50%. The pathogens were detected by direct Gram-stained smear in 86.4% of patients. Gram +ve bacteria was detected in 55/110 (50%) of cases. Gram -ve bacteria detected in 40/110 (36.4%) of cases. ABM carried a high mortality rate (22.7%). ABM had 22.7% mortality rate. Conclusions: Meningitis is endemic in Egypt with a significant mortality rate. Strept pneumonia was the most common offending organism.