A pesar de su baja incidencia la meningitis bacteriana tiene una alta morbimortalidad. En la del adulto adquirida en la comunidad el pneumococo y meningococo son sus principales agentes etiológicos. Su desarrollo depende de la interacción compleja entre factores bacterianos y la respuesta inmunológica del huésped. Su diagnóstico requiere el reconocimiento del síndrome clínico, la confirmación del proceso inflamatorio meníngeo y la identificación del agente etiológico en el líquido cefalorraquídeo. El tratamiento temprano con cubrimiento antibiótico de amplio espectro y luego dirigido según resultados de laboratorio reduce los desenlaces adversos. En este resumen narrativo se describen aspectos clínicos, fisiopatológicos, diagnósticos, terapéuticos y pronóstico de la meningitis bacteriana aguda del adulto adquirida en la comunidad.
Background Measurement of the optic nerve sheath diameter (ONSD) provides a rapid, safe, and easy method for detecting increased intracranial pressure (ICP). However, the normal mean and upper limit values may vary according to sex, age, ethnicity, and ultrasound technique. Aim We aimed to obtain the mean ONSD in a healthy Colombian adult population and to correlate it with demographic and anthropometric measures. Methods In a prospective study using a 10–13 MHz linear ultrasound probe, eye transverse diameter (ETD) and ONSD in the transverse (ONSD-TP) and sagittal planes (ONSD-SP) were measured in healthy adult volunteers in Bogota, Colombia. Results A total of 100 healthy subjects were included, with a mean age of 26,7 ± 8,3 years and 62 women. The mean ETD, ONSD-TP and ONSD-SP was 23.11 mm (95% confidence interval (CI): 22.90 mm-23.32 mm), 3.96 mm (95% CI: 3.85 mm-4.07 mm) and 4.0 mm (95% CI: 3.90 mm-4.11 mm), respectively. The ONSD in both planes ranged from 2.35 mm to 5.20 mm. There was a significant correlation between ONSD-SP and ONSD-TP (p < 0.0001) but no correlation between the ocular measures and demographic or anthropometric variables (p > 0.05). The intraclass correlation between the eyes was statistically significant. Conclusion Our study shows that ultrasound-measured ONSD in healthy adults in Colombia is similar to that found worldwide. An ONSD of 5.5 mm may be considered the upper limit for healthy adults in Colombia. ONSD can be measured in either plane; there is a good correlation between the two eyes; and ONSD is not modified by demographic or anthropometric characteristics.
Background Measurement of optic nerve sheath diameter (ONSD) provides a rapid, safe, and easy method for detecting increased intracranial pressure (ICP). However, normal mean and upper limit values may vary according to age, sex, ethnicity, and ultrasound laboratory. Aim We aim to obtain the mean of ONSD in a healthy Colombian adult population and correlate it with demographic and anthropometric measures. Methods In a prospective study using a 10-13MHz linear ultrasound probe, transverse bulb diameter (TBD) and ONSD in transverse (ONSD-TP) and sagittal plane (ONSD-SP) were measured in healthy adults volunteers in Bogota, Colombia. Results A 100 healthy subjects were included, mean age 26,7 ± 8,3 years with 62 women. For 95% of the subjects the mean TBD, ONSD-TP and ONSD-SP was 23.11mm (CI: 22.90mm-23.32mm), 3.96mm (CI: 3.85mm-4.07mm) and 4.0mm (CI: 3.90mm-4.11mm) respectively. ONSD in both planes ranged from 2.35mm to 5.20mm. There was a correlation between ONSD-SP and ONSD-TP (p < 0.0001) but no correlation between ocular measures and demographic or anthropometric variables (p > 0.05). Intraclass correlation between eyes was statistically significant. Conclusion Our study shows that ultrasound measured ONSD in healthy adults in Colombia is similar to those found worldwide. An ONSD of 5.5mm may be considered the upper limit for healthy adults in Colombia. ONSD could be measured in either plane, there is a good correlation between the two eyes and ONSD is not modified by demographic or anthropometric characteristics.
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