Predisposing Factors Responsible for the Occurrence of Bacterial Purulent Meningoencephalitis

Abstract

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.