title: [Prognostic factors in bacterial meningitis in adults. Retrospective analysis of 46 patients].
abstract: Clinical and laboratory data on 46 patients with acute bacterial meningitis were analyzed in a retrospective survey. The incidence of bacterial meningitis in hospital admissions was 1.3% and the mortality 33%. Streptococcus pneumoniae was the most frequent etiologic agent. Mortality was highest for pneumococcal meningitis and was higher in patients over 50 years of age (83% vs 25%, p less than 0.05). The initial stage of consciousness was prognostically important. All awake patients survived, while the more impaired the consciousness (from lethargy to coma), the higher the mortality (19%, 25%, and 78% respectively). Seizures and paresis of the third cranial nerve were significantly higher in lethal cases. Brain edema was the leading cause of death (60%). The interval between hospital admission and start of antibiotic treatment was crucial for prognosis. Patients who received the first dose of antibiotics within 3 hours after admission had a mortality of 13%, while a delay of 6-24 hours increased the mortality to 3/3.
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000382:microbiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008581:Meningitis / Q000209:etiology / Q000382:microbiology* / Q000401:mortality; D008585:Meningitis, Meningococcal / Q000188:drug therapy / Q000401:mortality; D008586:Meningitis, Pneumococcal / Q000188:drug therapy / Q000401:mortality; D009345:Neisseria meningitidis / Q000187:drug effects; D011379:Prognosis; D012189:Retrospective Studies; D012621:Seasons; D013290:Streptococcal Infections / Q000188:drug therapy / Q000401:mortality; D013557:Switzerland; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: Prognostische Faktoren bei der bakteriellen Meningitis des Erwachsenen. Eine retrospektive Analyse von 46 Patienten.