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Bacterial meningitis in Nottingham

Published online by Cambridge University Press:  19 October 2009

P. Ispahani
Affiliation:
Department of Microbiology and PHLS Laboratory, University Hospital, Nottingham, U.K.
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Summary

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Records of 171 cases of bacterial meningitis admitted to Nottingham hospitals from January 1974 to June 1980 were reviewed. The distribution of organisms producing meningitis and the factors influencing mortality in different age groups were assessed. Neisseria meningitidis, Haemophilus infiuenzae and Streptococcus pneumoniae accounted for 69% of all proven cases. The overall mortality was 26% being lowest in patients with meningococcal meningitis (0%) and highest in those with pneumococcal meningitis (53%). The following factors were associated with a poor prognosis: age more than 40 years, or less than 2 months; state of consciousness on admission; high CSF protein concentration; and a positive blood culture. There was no evidence that antibiotic therapy prior to admission affected prognosis. Although many laboratory findings were altered by prior treatment with antibiotics, this did not prevent the establishment of a diagnosis in the individual patient.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1983

References

REFERENCES

Baird, D. R., Whittle, H. C. & Greenwood, B. M. (1976). Mortality from pneumococcal meningitis. Lancet ii, 13441346.CrossRefGoogle Scholar
Carpenter, R. R. & Petersdorf, R. G. (1962). The clinical spectrum of meningitis. American Journal of Medicine 33, 262275.CrossRefGoogle ScholarPubMed
Chattopadhyay, B. (1980). Mortality from meningitis in a District General Hospital-a review of 67 cases. Public Health, Tendon 94, 7177.CrossRefGoogle Scholar
Converse, G. M., Gwaltney, J. M., Strassburo, D. A. & Hendley, J. O. (1973). Alteration of cerebrospinal fluid findings by partial treatment of bacterial meningitis. Journal of Pediatrics 83, 220225.CrossRefGoogle ScholarPubMed
Davey, P. G., Cruikshank, J. K., McManus, I. C., Mahmood, B., Snow, M. H. & Geddes, A. M. (1982). Bacterial meningitis—ten years experience. Journal of Hygiene, Cambridge 88, 383401.CrossRefGoogle ScholarPubMed
Editorial (1977). Partly treated pyogenic meningitis. British Medical Journal i, 340.Google Scholar
Editorial (1979). Meningococcal meningitis. British Medical Journal ii, 953.Google Scholar
Farries, J. S., Dickson, W., Greenwood, E., Malhotra, T. R., Annott, J. I.). & Jones, D. M. (1975). Meningococcal infections in Bolton, 1071–74. Lancet ii, 118120.CrossRefGoogle Scholar
Geiseler, P. J., Nelson, K. E., Levin, S., Reddi, K. T. & Moses, V. K. (1980). Community acquired purulent meningitis; a review of 1,316 cases during the antibiotic era 1054–1076; Reviews of Infectious Diseases 2, 725745.CrossRefGoogle Scholar
Geiseler, P. J., Nelson, K. E. & Levin, S. (1981). Community acquired purulent meningitis of unknown aetiology. Archives of Neurology 38, 740753.CrossRefGoogle Scholar
Goldacre, M. J. (1976). Acute bacterial meningitis in childhood. Incidence and mortality in a defined population. Lancet i, 2831.CrossRefGoogle Scholar
Goldacre, M. J. (1977). Acute bacterial meningitis in childhood: aspects of pre hospital care in 687 cases. Archives of Disease in Childhood 52, 501503.CrossRefGoogle Scholar
Heckmatt, J. Z. (1976). Coliform meningitis in the newborn. Archives of Disease in Childhood 51, 560573.CrossRefGoogle ScholarPubMed
Hodoes, G. R.& Perkins, R. L. (1975). Acute bacterial meningitis: an analysis of factors influencing prognosis. American Journal of Medical Sciences 270, 427440.Google Scholar
Jarvis, C. W. & Saxena, K. M. (1972). Does prior antibiotic treatment hamper the diagnosis of acute bacterial meningitis? Clinical Pediatrics 11, 201204.CrossRefGoogle ScholarPubMed
Kaiser, A. B. & McGhee, Z. A. (1975). Aminoglycoside therapy of gram-negative bacillary meningitis. New England Journal of Medicine 293, 12151220.CrossRefGoogle ScholarPubMed
Kennedy, D. H. & Fallon, R. J. (1979). Tuberculous meningitis. Journal of the American Medical Association 243 (iii), 264268.CrossRefGoogle Scholar
Landesman, S. H., Cokraoo, M. L., Shah, P. M., Armkkgaud, M., Barza, M. & Cherubin, C. E. (1981). Past and current roles of cephalosporin antibiotics in the treatment of meningitis. Emphasis on use in gram-negative bacillary meningitis. American Journal of Medicine 71, 693703.CrossRefGoogle ScholarPubMed
Laxey, R. M. & Marks, M. I. (1977). Pneumococca! meningitis in children. American Journal of Diseases in Children 131, 850853.Google Scholar
McCracken, G. H., Mize, S. G. & Thrkkeld, N. (1980). Intraventricular gentamicin therapy in gram-negative bacillary meningitis of infancy. Report of the Second Neonatal Meningitis Cooperative Study Group. Lancet i, 787791.Google Scholar
Mandal, B. K. (1976). The dilemma of partially treated bacterial meningitis. Scandinavian Journal of Infectious Diseases 8, 185188.CrossRefGoogle ScholarPubMed
Neal, J. B. (1935). Meningococcic meningitis in children. Journal of the American Medical Association 105, 568570.CrossRefGoogle Scholar
Pickens, S., Sanoster, G., Gray, J. A. & McMurdock, J. (1978). The effects of pre-admission antibiotics on the bacteriological diagnosis of pyogenic meningitis. Scandinavian Journal of Infectious Diseases 10, 183185.CrossRefGoogle ScholarPubMed
Quaade, F. & Kristensen, K. P. (1962). Purulent meningitis: a review of 658 cases. Ada Medica Scandinavica 171, 543550.CrossRefGoogle ScholarPubMed
Rahal, J. J. & Simbbrkoff, M.S. (1979). Bactericidal and bacteriostatic action of chloramphenicol against meningeal pathogens. Antimicrobial Agents and Chemotherapy 16, 1318.CrossRefGoogle Scholar
Romer, F. K. (1977 a). Bacterial meningitis. A 15 year review of bacterial meningitis from departments of internal medicine. Danish Medical Bulletin 24, 3540.Google ScholarPubMed
Romer, F. K. (1977 b). Difficulties in the diagnosis of bacterial meningitis. Evaluation of antibiotic pretreatment and causes of admission to hospital. Lancet ii, 345347.CrossRefGoogle Scholar
Swartz, M. N. (1981). Intraventricular use of aminoglycosides in the treatment of gram-negative bacillary meningitis: conflicting views. Journal of Infectious Diseases 143, 293296.CrossRefGoogle ScholarPubMed
Swartz, M. N. & Dodge, P.R. (1965). Bacterial meningitis-a review of selected aspects. New England Journal of Medicine 272, 725731.CrossRefGoogle ScholarPubMed
Ware, S. J. & McLauchlan, S. (1978). Hnemophilus meningitis in Portsmouth Lancet ii, 197199.CrossRefGoogle Scholar
Weiss, W., Figueroa, W.Shapiro, W. H. & Flippin, H. F. (1967). Prognostic factors in pneumococcal meningitis. Archives of Internal Medicine 120, 517524.CrossRefGoogle ScholarPubMed