title: [Community acquired bacterial meningitis in patients over 60].
abstract: Acute bacterial meningitis has a global mortality rate of 135000 cases per year. In Argentina over the last 12 years, the annual incidence rate has been 5.5/100 000. About 20% of patients present neurological sequelae, which are more common in patients aged 60 or older. Our objective here is to determine the clinical characteristics, the most common causes and to measure evolution in patients over 60 years old diagnosed with meningitis and treated at the Hospital de Clinicas José de San Martín. This is a retrospective study based on a review of medical records from 2003 to 2013 that takes into account patients older than 60 who were diagnosed with acute bacterial meningitis acquired in the community by a microbiological diagnosis of CSF or those included due to a high suspicion of bacterial meningitis (pleocitosis > 2000 cells/mm3, proteins > 220 mg/dl, glycorrhachia < 34 mg/dl, glycorrhachia/glucose index < 0.23). Cases of TB meningitis, nosocomial, postoperative and other nonbacterial meningitis were excluded. Sixty nine patients were included, 45 (65%) were women with an average age of 78 ± 10.6 years. Only 40% had the triad of classical meningitis symptoms (stiff neck, fever and altered mental status). In 52% of the patients germs developed in the CSF, the most frequent being Streptococcus pneumoniae present in 47% of cases. Lethality rate was 41%, all of them by methicillin-sensitive Staphylococcus aureus. Only 24 (35%) cases were admitted into intensive care. The main sequelae present were motor disorders (12%) and hearing loss (5%).
authors.affiliation: Servicio de Neurología, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Mora Mora
authors.forename: Micke E de
authors.initials: ME
authors.lastname: Arco Espinosa
authors.forename: Javier
authors.initials: J
authors.lastname: Plumet
authors.forename: Federico
authors.initials: F
authors.lastname: Micheli
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000382:microbiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000401:mortality; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000401:mortality
keywords: Staphylococcus aureus; Streptococcus pneumoniae; bacterial meningitis