RESUMO
Review of 497 cases of neuroinfections in 7 tropical clinics in Ethiopia, Uganda, Burundi, Kenya, Sudan within 2000-2007 was performed. 97.5% of all cases was cerebral malaria (40.1%) and bacterial meningitis (56.4%). TB meningitis, cerebral cryptococcosis and sleeping sickness were very rare.
Assuntos
Antibacterianos/uso terapêutico , Antimaláricos/uso terapêutico , Malária Cerebral/epidemiologia , Área Carente de Assistência Médica , Meningites Bacterianas/epidemiologia , África Subsaariana/epidemiologia , Artemeter , Artemisininas/uso terapêutico , Ceftriaxona/uso terapêutico , Cloranfenicol/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada , Humanos , Laboratórios/provisão & distribuição , Malária Cerebral/diagnóstico , Malária Cerebral/tratamento farmacológico , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/tratamento farmacológico , Quinina/uso terapêutico , Estudos Retrospectivos , Medicina TropicalRESUMO
Within last 17 years we went through all charts of bacterial meningitis within our nationwide survey and among 372 cases we found 62 cases of MM, in 12 cases with meningococcal disease (with shock, petechial effusions or disseminated intravascular coagulation or digital gangrenes). MM was usually observed in young adults without any of investigated risk factors like neoplasia, ENT (ear, nose, throat) focuses, elderly age, sepsis, diabetes, alcoholism, trauma, neonatal VLBW etc. Trauma, diabetes mellitus, alcohol abuse and chronic sinusitis/otitis were significantly less frequently found as a risk factor for MM. Mortality was very low, only 4.8% and was lower than overall mortality in CBM (12.4%, NS). Also the proportion of neurologic sequellae (9.7%) and initial treatment failure (8.1%) were comparable or even lower. This positive outcome results are probably because all N. meningitis strains were susceptible to penicillin, chloramphenicol, cefotaxim, cotrimoxazol or ciprofloxacin. Other reason for low mortality was that most cases received oral antibiotic immediately, even before admission (50 of 62). 95.2% of cases survived, 90.3% without any transient neurological residual symptoms.
Assuntos
Antibacterianos/uso terapêutico , Meningite Meningocócica/epidemiologia , Infecções Meningocócicas/epidemiologia , Medicina Tropical , Cefalosporinas/uso terapêutico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/mortalidade , Humanos , Meningite Meningocócica/tratamento farmacológico , Meningite Meningocócica/mortalidade , Infecções Meningocócicas/tratamento farmacológico , Infecções Meningocócicas/mortalidade , Avaliação de Resultados em Cuidados de Saúde , Penicilinas/uso terapêutico , Estudos Retrospectivos , Fatores de RiscoRESUMO
Community acquired bacterial (CBM) meningitis in diabetic patients was analyzed for risk factors and outcome in a cohort of 201 cases of meningitis within last 17 years: 15 patients with diabetes mellitus and meningitis were identified and compared for etiology and mortality as well as for neurologic sequellae with all CBM cases.