Meningococcal meningitis: clinical and laboratorial characteristics, fatality rate and variables associated with in-hospital mortality

Abstract

Meningococcal meningitis is a public health problem. The aim of this study was to describe the clinical characteristics of patients with meningococcal meningitis, and to identify associated factors with mortality. This was a retrospective study, between 2006 and 2011, at a referral center in São Paulo, Brazil. Logistic regression analysis was used to identify factors associated with mortality. We included 316 patients. The median age was 16 years (IQR: 7–27) and 60% were male. The clinical triad: fever, headache and neck stiffness was observed in 89% of the patients. The cerebrospinal triad: pleocytosis, elevated protein levels and low glucose levels was present in 79% of patients. Factors associated with mortality in the multivariate model were age above 50 years, seizures, tachycardia, hypotension and neck stiffness. The classic clinical and laboratory triads of meningococcal meningitis were variable. The fatality rate was low. Age, seizures and shock signs were independently associated with mortality.

Adherence to international guidelines for the treatment of meningitis infections in Lebanon

“…Risk factors found to be associated with poor prognosis were old age, and inappropriate treatment. The mortality rate increases linearly with increasing age, being highest in elderly patients (51.7%), in contrast to the results of Strelow et al,16 which concluded that age and mortality were independent, but consistent with those of Choi 17…”

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

“…We found additional studies specifically reporting on S pneumoniae (113 studies; 24 553 episodes) (eTable 8 in Supplement 1), N meningitidis (75 studies; 100 278 episodes) (eTable 9 in Supplement 1), H influenzae (49 studies; 28 796 episodes) (eTable 10 in Supplement 1), L monocytogenes (15 studies; 985 episodes) (eTable 11 in Supplement 1),…”

“…N meningitidis was among the most frequent pathogens in children and adults (250 studies; 274 study periods; 123 830 episodes) (eTable 16 and eFigure 27 in Supplement 1). This sample was dominated by a Nigerian study describing an outbreak in 2009 with more than 50 000 patients . The overall CFR was 8.8% (95% CI, 8.0% to 9.7%) (eFigure 28 in Supplement 1); CFR was 11% (95% CI, 8% to 16%) before 1961 and 7.2% (95% CI, 5.8.% to 8.7%) i...…”

Epidemiological burden of meningococcal disease in Latin America: A systematic literature review

“…Regarding subjects with MM, a 20.9% CFR was found in Brazil for 2000-2006 (Vasconcelos et al, 2011) and 5.4% for 2006-2011 (Strelow et al, 2016). Stratifying by age, the MMrelated CFR was lower in children aged 5 years and 5-15 years 2007: NR 2007: NR 2007: NR 2007: NR Nunes et al, 2016 7 (11.9) 2 (3.4) 2 (3.4) 5 (8.5) NR 6.8 5.1% c Tauil et al, 2014 (Brazil) 2005 1993-1996: NR 1993-1996: NR (43) Baethgen et al, 2008 (Brazil) 229 ( 79) 41 (14.1) 18 (6.2) 2 (0.7) NR NR NR Weidlich et al, 2008 (Brazil) NR ( 64) NR ( 18) NR ( 17 Weckx et al, 2017 (Brazil) 1-4 years: 3 (NR) 1-4 years: 2 (NR) 1-4 years: 1 (NR) 5-9 years: 2 (NR) NR NR 1-4 years: 14 h (NR) 5-9 years: 2 (NR) 5-9 years: 1 (NR) 10-14 years: 2 (NR) 5-9 years: 13 h (NR) 10-14 years: 1 (NR) 10-14 years: 5 (NR) (2.8% and 6.6%, respectively), and increased in subjects aged >50 years (22.7%) (Strelow et al, 2016). During a 2012 outbreak of serogroup W in Chile, the CFR was approximately 27% (Valenzuela et al, 2013).…”

“…For MM cases, from 2000 to 2006, serogroup B was more prevalent in Brazil, followed by serogroup C (Vasconcelos et al, 2011). From 2006 to 2011, serogroup C became the most prevalent (Strelow et al, 2016).…”