Bacterial meningitis in adults at the University of Calabar Teaching Hospital. A5-year retrospective study 1993-97
AbstractA retrospective study of cases of adult Bacterial meningitis managed at the University of Calabar Teaching Hospital Calabar over a 5 –Year period (1993-97) was carried out to determine the Clinical presentation, morbidity and the management outcomes during the survey period. A total of 68 patients whose case records were found intact were selected for the study. The case records of these patients were reviewed for clinical features on presentation, the initial results of investigations mainly lumber puncture and cerebrospinal fluid analysis and nature of culprit organism. The management outcome of each patient was also noted.
The study reveled that forty one out of 66 patients recovered fully from the illness after treatment, nineteen patients died and six patients left against medical advice. The predicator of morbidity and mortality were (a) late presentation with altered levels of consciousness or outright coma; (b) early presentation while fully conscious and (c) inadequate/ inappropriate medication prior to arrived in hospital. Mortality rate was higher among patients who received inadequate antibiotics, presented late for treatment; and in those presenting with altered level of consciousness. The mortality rate was 59 and 52% respectively. The values for each category were statistically significant when compared with mortality rates of patients who presented very early for treatment, had adequate doses of antibiotics, and were fully conscious on arrival and during treatment, p<0.05.
The common complications associated with adult bacterial meningitis were septicemia, aspiration pneumonia and cranial nerve palsies. Bacterial meningitis still remains an important cause of morbidity and mortality in this environment. Adequate therapeutic coverage, health education, and immunization where available, are required to control the scourge of this disease.
Key Words: Adult Meningitis, Calabar.
(Global Jnl of Med Sci: 2003 2(1): 1-6)