Abstract
BackgroundTo examine the clinical characteristics of bacterial meningitis in elderly patients.Methods261 patients with adult bacterial meningitis (ABM), collected during a study period of 11 years (2000-2010), were included for study. Among them, 87 patients aged ≥ 65 years and were classified as the elderly group. The clinical and laboratory characteristics and prognostic factors were analyzed, and a clinical comparison with those of non-elderly ABM patients was also made.ResultsThe 87 elderly ABM patients were composed of 53 males and 34 females, aged 65-87 years old (median = 71 years). Diabetes mellitus (DM) was the most common underlying condition (34%), followed by end stage renal disease (7%), alcoholism (4%) and malignancies (4%). Fever was the most common clinical manifestation (86%), followed by altered consciousness (62%), leukocytosis (53%), hydrocephalus (38%), seizure (30%), bacteremia (21%) and shock (11%). Thirty-nine of these 87 elderly ABM patients had spontaneous infection, while the other 48 had post-neurosurgical infection. Forty-four patients contracted ABM in a community-acquired state, while the other 43, a nosocomial state. The therapeutic results of the 87 elderly ABM patients were that 34 patients expired and 53 patients survived. The comparative results of the clinical and laboratory characteristics between the elderly and non-elderly ABM patients showed that only peripheral blood leukocytosis was significant. Presence of shock and seizure were significant prognostic factors of elderly ABM patients.ConclusionsElderly ABM patients accounted for 34.8% of the overall ABM cases, and this relatively high incidence rate may signify the future burden of ABM in the elderly population in Taiwan. The relative frequency of implicated pathogens of elderly ABM is similar to that of non-elderly ABM. Compared with non-elderly patients, the elderly ABM patients have a significantly lower incidence of peripheral blood leukocytosis. The mortality rate of elderly ABM remains high, and the presence of shock and seizures are important prognostic factors.
Highlights
To examine the clinical characteristics of bacterial meningitis in elderly patients
The study of bacterial meningitis with a focus only on elderly patients has rarely been solely examined in the related literature [2,3,4]
We retrospectively reviewed microbiological records for cerebrospinal fluid (CSF) and the medical records of patients with adult bacterial meningitis (ABM) admitted to the Chang Gung Memorial Hospital (CGMH)-Kaohsiung over a period of 11 years (2000 - 2010)
Summary
To examine the clinical characteristics of bacterial meningitis in elderly patients. People are vulnerable to infectious diseases, and may present with fewer classic signs and symptoms for clinical identification [1]. The study of bacterial meningitis with a focus only on elderly patients has rarely been solely examined in the related literature [2,3,4]. In the United States, because of the success of conjugate vaccines in reducing the risk of major pathogens-related meningitis [3,4]. In this study, we analyzed the clinical and laboratory characteristics and the therapeutic outcome of 87 elderly ABM patients and made a clinical comparison with those of with bacterial meningitis in a nonelderly group
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