Akutni bakterijski meningitisi u Zlatiborskom okrugu

Abstract

Introduction: Acute bacterial meningitis is present worldwide, with a lethality rate up to 50%. The most common causes are Streptococcus pneumoniae and Neisseria meningitidis. The aim of the research is to analyze acute bacterial meningitis in the Zlatibor district. Material and methods: Patients treated at the General Hospital in Uzice were examined retrogradely. Demographic data, risk factors, hematological and biochemical data from blood and cerebrospinal fluid and the findings of computed tomography scan of the endocranium were analyzed. All patients underwent lumbar puncture. The etiological diagnosis was made by identifying the pathogens from cerebrospinal fluid or blood culture. The clinical course was monitored, and the prognosis was determined according to the Glasgow coma scale. Results: We examined 148 patients with acute bacterial meningitis (92 men, 56 women), mean age 55.8 +/-13.1. Half of the patients had comorbidities. In 42%, the possible focus of infection was sinusitis. Main symptoms were headache (100%), fever (97.2%), neck stiffness (95.9%). CSF analysis showed less than 100 polymorphonuclear leukocytes/mm3 in 65% of patients, and CSF protein elevation in 95.3%. 94.6% of patients had leukocytosis in the blood, and 86.5% had elevated C-reactive protein. The most commonly isolated bacterium was Streptococcus pneumoniae (40.5%). 74.3% of patients had a favorable disease outcome. One third of the patients showed epileptic seizures. In 16.2% of patients, the disease ended lethally. Risk factors for lethal outcome were the presence of comorbidities, Streptococcus pneumoniae as the pathogen, the occurrence of epileptic seizures, age over 50 years and male gender. Conclusion: The most common cause of acute bacterial meningitis in adult population of the Zlatibor district is Streptococcus pneumoniae, which is also the most common cause of adverse disease outcomes. Majority of patients are men over the age of 50 with comorbidities, which are also a risk group for an unfavorable disease outcome.