Epidemiology of Meningitis Studied at a University Hospital in Zahedan, South-Eastern Iran

Abstract

Background:Meningitis is an inflammation of the membranes, which surround the brain and spinal cord. Early treatment of bacterial meningitis can prevent serious complications. In the last two decades, three vaccines have been developed against the three main bacterial species implicated in meningitis of children in western countries and vaccine-preventable invasive bacterial meningitis has decreased substantially in the past few years. However, none of the developed vaccines are part of our childhood immunization schedule. Objectives: This study aimed to search the epidemiology of meningitis in Zahedan. Patients and Methods:In this cross-sectional survey, we studied all patients with meningitis for ten years, from May 2004 to May 2014, who had been referred to our hospital. The patients were evaluated according to their sex, age, clinical features, risk factors, pathogenic microorganisms, form of infection (acute or chronic) and clinical outcome. Results: Among the 53 patients with meningitis (47% females; 53% males with mean age 36 years) 47 cases (83%) had acute meningitis and six cases (17%) had chronic meningitis (four cases of tuberculosis and two cases of brucellosis). From the 47 cases with acute meningitis, only one case had a positive cerebrospinal fluid (CSF) culture for meningococci and 46 patients had negative CSF culture. The most common clinical symptoms was fever and headache (90%) and the least was seizure (9%). Mortality rate was 7.5% (4 cases). There were no significant risk factors except for two patients with acute meningitis and two cases with chronic meningitis. Conclusions: According to negative CSF cultures in acute meningitis, CSF culture using the BACTEC automated system and specific viral tests is recommended for detection of the etiological agents of viral and bacterial meningitis, particularly in the Iranian population where patients use antibiotics without prescription.

The Etiological Spectrum of Febrile Encephalopathy in Adult Patients: A Cross-Sectional Study from a Developing Country

“…Despite the reported yields of 70–85% for CSF culture, as well as 50–90% for blood culture in bacterial meningitis [ 43 , 44 ], the yields in our study were only around 25% and 12%, respectively. There could be several possible explanations for the relatively low rate of microbiological documentation that was observed in our study and some previous studies from Iran [ 45 , 46 ], including the higher proportion of patients who received antimicrobials before presentation, delay in performing diagnostic tests including LP, improper collection of clinical specimen and transport in the environment to the laboratory, inadequately accurate culture-based microbiological techniques [ 47 ], and the limited use of molecular diagnostic tests such as PCR, except for certain pathogens such as herpes simplex virus in our healthcare centers.…”

The Risk Factors of Bacterial Meningitis in Late-Onset Neonatal Sepsis

“…In a study of Sharifi-Mood et al, 46 (86.79%) of 53 patients with meningitis had negative CSF culture results. The negative results of CSF culture in most cases of meningitis can be caused by previous use of antibiotics or inappropriate culture media [21].…”

Approaching Headaches—A Guide to Differential-Diagnostic Considerations and Causal Claims

“…Acute rhinosinusitis I: 17540 per 100,000 persons per year [27] 29% [28] Bacterial meningitis I: 1.49 per 100,000 persons per year [29] 84% to 90% [30][31][32] Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) P: 1.32 to 1.98 definite cases per 100,000 adults [33,34] 45% to 55% [35,36] Cerebral ischaemic event I: 156 per 100,000 persons per year [37] 7% to 34% [38] Table 1. Cont.…”