RESUMEN
Craniocerebral trauma is one of major risk factors for development of meningitis. We reviewed 30 cases of bacterial meningitis occurring in community after craniocerebral trauma. Alcohol abuse was significant risk factor occurring in trauma patients with meningitis present in 50% in our cohort (p=0.0001). The most common pathogen in posttraumatic meningitis was Str. pneumoniae (90% vs. 33.8%, p=0.0001). However mortality was very low, only 5% probably because of early diagnosis and treatment of patients at risk for bacterial meningitis but neurologic sequellea were significantly more common (p=0.00001) in patients after craniocerebral trauma.
Asunto(s)
Trastornos Relacionados con Alcohol/complicaciones , Traumatismos Craneocerebrales/complicaciones , Meningitis Bacterianas/etiología , Antibacterianos/uso terapéutico , Bacterias/clasificación , Bacterias/patogenicidad , Daño Encefálico Crónico/etiología , Daño Encefálico Crónico/prevención & control , Estudios de Cohortes , Infecciones Comunitarias Adquiridas/etiología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/mortalidad , Infecciones Comunitarias Adquiridas/terapia , Humanos , Meningitis Bacterianas/microbiología , Meningitis Bacterianas/mortalidad , Meningitis Bacterianas/terapia , Evaluación de Resultado en la Atención de Salud , Factores de RiesgoRESUMEN
Within last 17 years we went through all charts of bacterial meningitis within our nationwide survey and among 372 cases we found 62 cases of MM, in 12 cases with meningococcal disease (with shock, petechial effusions or disseminated intravascular coagulation or digital gangrenes). MM was usually observed in young adults without any of investigated risk factors like neoplasia, ENT (ear, nose, throat) focuses, elderly age, sepsis, diabetes, alcoholism, trauma, neonatal VLBW etc. Trauma, diabetes mellitus, alcohol abuse and chronic sinusitis/otitis were significantly less frequently found as a risk factor for MM. Mortality was very low, only 4.8% and was lower than overall mortality in CBM (12.4%, NS). Also the proportion of neurologic sequellae (9.7%) and initial treatment failure (8.1%) were comparable or even lower. This positive outcome results are probably because all N. meningitis strains were susceptible to penicillin, chloramphenicol, cefotaxim, cotrimoxazol or ciprofloxacin. Other reason for low mortality was that most cases received oral antibiotic immediately, even before admission (50 of 62). 95.2% of cases survived, 90.3% without any transient neurological residual symptoms.
Asunto(s)
Antibacterianos/uso terapéutico , Meningitis Meningocócica/epidemiología , Infecciones Meningocócicas/epidemiología , Medicina Tropical , Cefalosporinas/uso terapéutico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/mortalidad , Humanos , Meningitis Meningocócica/tratamiento farmacológico , Meningitis Meningocócica/mortalidad , Infecciones Meningocócicas/tratamiento farmacológico , Infecciones Meningocócicas/mortalidad , Evaluación de Resultado en la Atención de Salud , Penicilinas/uso terapéutico , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Community acquired bacterial (CBM) meningitis in diabetic patients was analyzed for risk factors and outcome in a cohort of 201 cases of meningitis within last 17 years: 15 patients with diabetes mellitus and meningitis were identified and compared for etiology and mortality as well as for neurologic sequellae with all CBM cases.