[Etiology and results of treatment of adults with bacterial encephalomeningitis].
Results of treatment and outcomes of 89 adults with purulent encephalomeningitis, treated in years 1996-2002 in the Department of Infectious Diseases and Hepatology, Medical University of Lodz, were analyzed. Eighty nine patients were retrospectively included into the study. Results of treatment were evaluated at the last day of patient's hospitalization, and classified as: cure, disability or death. Results of treatment were analyzed in relation to etiology of purulent encephalomeningitis, age and gender of patients, course of the disease, and time from the onset of symptoms to admission to the Department. No statistically significant correlations between age, gender and prognosis were found. Thirty seven out of 89 patients were cured (41.6%); 29 of 89 patients died (32.6%); in 18 patients (19/89; 20.2) disability was diagnosed. In remaining 5 cases (5.6%), the result of treatment remained unknown. These patients were transferred to Intensive Care Units, outside our Hospital. In the studied group, etiologic factor was identified in 40 out of 89 cases (44.9%). In 40 patients, positive results of bacterial examination of cerebrospinal fluid were achieved. In 22 out of these 40 cases (55.0%), Streptococcus pneumoniae was identified as the etiologic factor. Higher percentage of patients died in subgroup with known etiology than in in subgroup of unknown etiology (p = 0.02). Higher percentage of cases with unconsciousness and higher percentage of cases with respiratory insufficiency were diagnosed in patients who died, than in patients who were cured (p = 0.00001).


CONCLUSIONS
1. Purulent meningoencephalitis in adults, despite progress in antibiotic treatment, is still a serious condition, with poor prognosis. 2. Diagnostics and treatment modalities of purulent meningo-encephalitis should be urgently extended in order to achieve better outcomes in these group of patients.
Klinika Chorób Zakaźnych i Hepatologii, Katedra Chorób Zakaźnych Uniwersytetu Medycznego w Łodzi. annapierar@op.pl
Anna
A
Piekarska
Joanna
J
Zboińska
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D002555:Cerebrospinal Fluid / Q000382:microbiology; D013293:Enterococcus faecalis / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000134:cerebrospinal fluid / Q000382:microbiology* / Q000401:mortality / Q000628:therapy; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000302:isolation & purification; D011379:Prognosis; D012189:Retrospective Studies; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult