title: Neuroinfection survey at a neurological ward in a Brazilian tertiary teaching hospital.
abstract: OBJECTIVE
  This study was undertaken to characterize the neuroinfection profile in a tertiary neurological ward.
  
  
  BACKGROUND
  Neuroinfection is a worldwide concern and bacterial meningitis, tetanus and cerebral malaria have been reported as the commonest causes in developing countries.
  
  
  METHODS
  From 1999 to 2007, all patients admitted to the Neurology Ward of Hospital das Clínicas, São Paulo University School of Medicine because of neuroinfection had their medical records reviewed. Age, gender, immunological status, neurological syndrome at presentation, infectious agent and clinical outcome were recorded.
  
  
  RESULTS
  Three hundred and seventy four cases of neuroinfectious diseases accounted for 4.2% of ward admissions and the identification of infectious agent was successful in 81% of cases. Mean age was 40.5 + 13.4 years, 63.8% were male, 19.7% were immunocompromised patients and meningoencephalitis was the most common clinical presentation despite infectious agent. Viruses and bacteria were equally responsible for 29.4% of neuroinfectious diseases; parasitic, fungal and prion infections accounted for 28%, 9.6% and 3.5% respectively. Human immunodeficiency virus (HIV), herpes simplex virus 1 (HSV1), Mycobacterium tuberculosis, Treponema pallidum, Taenia solium, Schistosoma mansoni, Cryptococcus neoformans and Histoplasma capsulatum were the more common infectious pathogens in the patients. Infection mortality rate was 14.2%, of which 62.3% occurred in immunocompetent patients.
  
  
  CONCLUSIONS
  Our institution appeared to share some results with developed and developing countries. Comparison with literature may be considered as quality control to health assistance.
authors.affiliation: Neurology Department, Faculdade de Medicina, Hospital das Clinicas, Universidade de São Paulo, São Paulo, Brazil. marchiori@hcnet.usp.br
authors.forename: Paulo E
authors.initials: PE
authors.lastname: Marchiori
authors.forename: Angelina M M
authors.initials: AM
authors.lastname: Lino
authors.forename: Luis R
authors.initials: LR
authors.lastname: Machado
authors.forename: Livia M
authors.initials: LM
authors.lastname: Pedalini
authors.forename: Marcos
authors.initials: M
authors.lastname: Boulos
authors.forename: Milberto
authors.initials: M
authors.lastname: Scaff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002493:Central Nervous System Diseases / Q000453:epidemiology*; D003141:Communicable Diseases / Q000453:epidemiology*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology; D010272:Parasitic Diseases; D012189:Retrospective Studies; D014777:Virus Diseases / Q000453:epidemiology; D055815:Young Adult