title: Meningococcal meningitis: clinical and laboratorial characteristics, fatality rate and variables associated with in-hospital mortality.
abstract: Meningococcal meningitis is a public health problem. The aim of this study was to describe the clinical characteristics of patients with meningococcal meningitis, and to identify associated factors with mortality. This was a retrospective study, between 2006 and 2011, at a referral center in São Paulo, Brazil. Logistic regression analysis was used to identify factors associated with mortality. We included 316 patients. The median age was 16 years (IQR: 7-27) and 60% were male. The clinical triad: fever, headache and neck stiffness was observed in 89% of the patients. The cerebrospinal triad: pleocytosis, elevated protein levels and low glucose levels was present in 79% of patients. Factors associated with mortality in the multivariate model were age above 50 years, seizures, tachycardia, hypotension and neck stiffness. The classic clinical and laboratory triads of meningococcal meningitis were variable. The fatality rate was low. Age, seizures and shock signs were independently associated with mortality.
authors.affiliation: Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Doenças Infecciosas, São Paulo SP, Brasil.
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Strelow
authors.affiliation: Universidade de São Paulo, Hospital Universitário, Divisão de Clínica Médica, São Paulo SP, Brasil.
authors.forename: Érique José F Peixoto de
authors.initials: ÉJ
authors.lastname: Miranda
authors.affiliation: Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Doenças Infecciosas, São Paulo SP, Brasil.
authors.forename: Karin R
authors.initials: KR
authors.lastname: Kolbe
authors.affiliation: Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Doenças Infecciosas, São Paulo SP, Brasil.
authors.forename: Juliana V Souza
authors.initials: JV
authors.lastname: Framil
authors.affiliation: Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Neurologia, São Paulo SP, Brasil.
authors.forename: Augusto Penalva de
authors.initials: AP
authors.lastname: Oliveira
authors.affiliation: Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Neurologia, São Paulo SP, Brasil.|Universidade de São Paulo, Hospital das Clinicas, Divisão de Moléstias Infecciosas, São Paulo SP, Brasil.|Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Laboratório de Investigação Médica (LIM) 49, São Paulo SP, Brasil.
authors.forename: José E
authors.initials: JE
authors.lastname: Vidal
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007022:Hypotension / Q000150:complications; D008297:Male; D008585:Meningitis, Meningococcal / Q000150:complications / Q000401:mortality*; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications; D013610:Tachycardia / Q000150:complications; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D055815:Young Adult