Meningitis in structure of patients with neuroinfections
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TARNOVSCHI, Eugeniu. Meningitis in structure of patients with neuroinfections. In: MedEspera: International Medical Congress for Students and Young Doctors, Ed. 7th edition, 3-5 mai 2018, Chişinău. Chisinau, Republic of Moldova: 2018, 7, p. 57.
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MedEspera
7, 2018
Congresul "International Medical Congress for Students and Young Doctors"
7th edition, Chişinău, Moldova, 3-5 mai 2018

Meningitis in structure of patients with neuroinfections


Pag. 57-57

Tarnovschi Eugeniu
 
”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
Disponibil în IBN: 2 noiembrie 2020


Rezumat

Introduction. Despite modern technologies and improved clinical care, meningitis remains an unsolved problem that leads to high morbidity and mortality rates worldwide. Aim of the study. To evaluate the structure of meningitis in adults; to determine the risk factors in correlation with clinical outcomes, as well as the etiological factors of adult meningitis. Materials and methods. It is a retrospective observ ational study conducted in Institute on Neurology and Neurosurgery from medical records of patients from 2015 to 2016 in the Neuroemergency section. 25 patients aged between 19 and 67 years with confirmed diagnose of meningitis were selected. The outcome w as unfavorable for 15 patients ( 9 of them ( from both groups died. We evaluate the clinical features of the patients, cerebrospinal fluid, and the imagistic and laboratory tests. Results. From cerebrospinal fluid examination we selected 18 cases ( of septic meningitis and 7 cases ( of aseptic meningitis. From clinical features we established a rate of 64% of the classic meningitis triad, and a rate of 44% of the alternative meningi tis triad. Only in 7 ( of 25 meningitis the causal agent was identified: twice Treponema palidum, twice E.coli haemolyticum, Enterococcus Faecium, Streptococcus Viridans and Mycobacterium tuberculosis. The imagistic examination showed signs of meningit is only in 20% of the cases. Out of the laboratory tests we established the highest values of blood glucose in dead patients with septic meningitis (9.87 mmol/l). We have also determined an Odds ratio of 12 ( CI 1.07 to 134.11, P<0.05) of correlation be tween death risk and diabetes mellitus in patients with meningitis. Other negative predictive factors were the following: high levels of erythrocyte sedimentation rate, low platelets count, high level of blood urea and creatinine. Conclusions. The presence of diabetes in meningitis patients increased the mortality by 12. Diabetes is a strong independent risk factor for death in community acquired adult bacterial meningitis. Other risk factors for negative outcome in meningitis patients were: hi gh level of cell counts in cerebrospinal fluid, high level of blood erythrocyte sedimentation rate, urea and creatitine.

Cuvinte-cheie
Meningitis, cerebrospinal fluid, diabetes.