Magnetic Resonance Imaging and Dexamethasone Therapy for Bacterial Meningitis

Dexamethasone and bacterial meningitis in Pakistan.

“…Although an overall (9) 2 (6) mortality of 19% is higher than reported in (12) 8 (23) most US and European studies, mortality in (6) 3 (9) studies from Pakistan range between 18 and (6) 1 (3) 29%. '7 " In our study, factors relating to late 26 32,125 (3) presentation-duration of illness more than four days and impaired consciousness at (39) 11 (34) admission-were the only significant predic-(39) 4 (16) tors of mortality. Other investigators have (4) 1 (4) reported increased mortality in patients with delays in diagnosis and impaired consciousness from other causes, one lost to follow up.…”

The role of dexamethasone in the treatment of bacterial meningitis – a systematic review

“…In contrast to these findings, three studies in two publications by Lebel et al . suggested a positive effect on hearing loss in children with meningitis, predominantly when caused by H. influenzae (moderate or more severe bilateral hearing impairment, study 1 and 2 combined, dexamethasone vs. placebo, 3 vs. 15%).…”

Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study

“…Mortality in our study was significantly lower in children who received adjunctive dexamethasone treatment but our study was not a randomised trial with matched groups. Most studies from high-income countries have demonstrated higher survival rates and improved overall outcomes following dexamethasone in the treatment of bacterial meningitis [ 30 ], such as studies from USA (all were children) [ 31 , 32 ], France (all were children) [ 33 ], and Europe (all were adults) [ 34 ]. By contrast, several studies from low- and middle-income countries have not shown a clear benefit of dexamethasone [ 30 ], such as studies from Malawi (all were children with 24% HIV positive) [ 35 ], India (all were children with HIV status unknown) [ 36 ], Egypt (all were children HIV status unknown) [ 37 ], and Mozambique (HIV status unknown) [ 38 ].…”