Guidelines for the management of acute meningitis in children and adults in South Africa

Boyles, Tom; Bamford, Colleen; Bateman, K.; Dramowski, Angela; Karstaedt, Alan; Korsman, Stephen N.J.; Roux, David M le; Maartens, Gary; Sa, Madhi; Naidoo, Ria; Nuttall, James; Reubenson, Gary; Taljaard, Jantjie; Thomas, Janet A.; Zyl, Gert van; Gottberg, Anne von; Whitelaw, Andrew; Mendelson, Marc

doi:10.1080/10158782.2013.11441513

Cited by 22 publications

(34 citation statements)

References 30 publications

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“…[15] Consistent CSF findings with acute bacterial meningitis include a polymorphonuclear pleocytosis, hypoglycorrhachia and a raised CSF protein level. [2,8,16] Despite our patient's reduced CSF glucose and raised protein, the inconsistent polymorph cell count was striking. Based on clinical suspicion, CSF and laboratory determinants, she was treated for acute bacterial meningitis.…”

Section: Discussionmentioning

confidence: 99%

“…[12] The classic clinical signs of Kernig and Brudzinski have value in ruling in the diagnosis of meningitis; however, these traditional signs have poor sensitivity and their absence cannot be used to rule out the disease. [8,13,14] The performance of a lumbar puncture is fundamental, as CSF examination is needed to establish the diagnosis. [15] Consistent CSF findings with acute bacterial meningitis include a polymorphonuclear pleocytosis, hypoglycorrhachia and a raised CSF protein level.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic challenges with acellular bacterial meningitis

Moolla

Naidoo

2016

S Afr Med J

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnostic challenges with acellular bacterial meningitis

Moolla

Naidoo

2016

S Afr Med J

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“…Th e death rate from the disease, despite the improved diagnostics, use of powerful antibiotics and other therapeutic methods, is relatively high, i.e. up to 30% 3,[10][11][12][13] . Th e majority of patients are over 40 years old, which makes 63% or 70% of treated persons.…”

Section: Discussionmentioning

confidence: 99%

“…It is unknown how predisposing factors aff ect disease outcome in patients with BPME. According to literature data, the risk factors and their impact on the course and outcome of the disease vary considerably [10][11][12][13] . Th erefore, it is necessary to defi ne the predisposing factors that are of paramount importance in each individual region.…”

Section: Introductionmentioning

confidence: 99%

Predisposing Factors Responsible for the Occurrence of Bacterial Purulent Meningoencephalitis

Dupanovic

Gajovıc

Terzic

et al. 2017

acc

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SUMMARY -Bacterial purulent meningoencephalitis (BPME) is a life-threatening infectious disease caused by various pyogenic bacteria. Th e disease is defi ned as the infl ammatory process of leptomeninges (visceral layer, pia mater and arachnoid membrane) and brain parenchyma with exudates in the subarachnoid space and surrounding brain structures. Th e aim of the study was to defi ne the predisposing factors responsible for the occurrence of BPME, as well as the possible correlation between the presence of predisposing factors and patient demographic characteristics, etiology and outcome of the disease. Th is retrospective-prospective study included 90 patients with BPME confi rmed by clinical, neuroradiological and laboratory fi ndings. Multivariate logistic regression models were fi tted to analyze the impact of the predisposing factors on the disease outcomes. Predisposing factors that were related to BPME were found in 61% of patients. Cranial trauma as the leading factor was recorded in 23.3% of patients, followed by previous neurological disease in 14.4% of patients, while 13 patients were exposed to previous chemotherapy or long-term corticosteroid therapy. Cardiovascular diseases were reported in 12.2% and diabetes in 7.8% of patients. Th e existence of cardiovascular diseases signifi cantly infl uenced unfavorable outcome of the disease, i.e. "deceased" in comparison to "cured" (OR=8.418; 95% CI=1.007-76.270), independently of age and gender. None of the examined predisposing factors was signifi cantly related to the "recovered with sequels" outcome as compared with "cured" outcome. Older age and presence of cardiovascular disease as a predisposing factor signifi cantly increased the odds of the BPME unfavorable outcome "deceased" as compared to "cured" outcome.

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“…To determine whether patients with meningitis caused by ceftriaxone-nonsusceptible isolates were more likely to die, we examined inhospital mortality, regardless of the length of hospital stay, in meningitis patients who were treated according to current local meningitis guidelines for ceftriaxone-susceptible disease, namely, third-or fourth-generation cephalosporin, imipenem, or meropenem (19). Patients who received a cephalosporin plus vancomycin were excluded, as this was not recommended in our guidelines at the time.…”

Section: Methodsmentioning

confidence: 99%

Factors Associated with Ceftriaxone Nonsusceptibility of Streptococcus pneumoniae: Analysis of South African National Surveillance Data, 2003 to 2010

Mollendorf

Cohen

Gouveia

et al. 2014

Antimicrob Agents Chemother

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It is important to monitor ␤-lactam antimicrobial nonsusceptibility trends for Streptococcus pneumoniae to inform empirical treatment guidelines. In this study, we describe penicillin and ceftriaxone susceptibility trends using national laboratorybased pneumococcal surveillance data from 2003 to 2010. A sentinel enhanced-site patient subset (2009 to 2010) contributed to the risk factor and mortality analyses. We included 9,218 invasive pneumococcal disease (IPD) cases for trend analyses and 2,854 IPD cases for risk factor and mortality analyses. Overall, we detected no significant changes in penicillin (patients <5 years of age, P ‫؍‬ 0.50; patients >5 years of age, P ‫؍‬ 0.05) or ceftriaxone nonsusceptibility rates (patients <5 years of age, P ‫؍‬ 0.21; patients >5 years of age, P ‫؍‬ 0.60). Factors associated with ceftriaxone nonsusceptibility on multivariate analysis were an age of <5 years (<1 year of age: adjusted odds ratio . Among patients >5 years of age with meningitis who were treated according to current guidelines, HIV-infected patients (aOR, 2.94; 95% CI, 1.32 to 6.54) and patients infected with ceftriaxone-nonsusceptible isolates (aOR, 3.17; 95% CI, 1.27 to 7.89) had increased mortality rates. Among children <5 years of age with meningitis, mortality was increased in HIV-infected patients (aOR, 3.04; 95% CI, 1.40 to 6.56) but not in those with ceftriaxone-nonsusceptible isolates. Penicillin and ceftriaxone nonsusceptibility remained stable over the study period. Ceftriaxone nonsusceptibility was associated with increased mortality among patients >5 years of age with meningitis.

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Guidelines for the management of acute meningitis in children and adults in South Africa

Cited by 22 publications

References 30 publications

Diagnostic challenges with acellular bacterial meningitis

Diagnostic challenges with acellular bacterial meningitis

Predisposing Factors Responsible for the Occurrence of Bacterial Purulent Meningoencephalitis

Factors Associated with Ceftriaxone Nonsusceptibility of Streptococcus pneumoniae: Analysis of South African National Surveillance Data, 2003 to 2010

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