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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(11): 875-880
DOI: 10.1590/0004-282X20160143
ARTICLE

Meningococcal meningitis: clinical and laboratorial characteristics, fatality rate and variables associated with in-hospital mortality

Meningite meningocócica: características clínicas e laboratoriais, taxa de letalidade e variáveis associadas com mortalidade intra-hospitalar
Vanessa L. Strelow
1   Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Doenças Infecciosas, São Paulo SP, Brasil;
,
Érique José F. Peixoto de Miranda
3   Universidade de São Paulo, Hospital Universitário, Divisão de Clínica Médica, São Paulo SP, Brasil;
,
Karin R. Kolbe
1   Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Doenças Infecciosas, São Paulo SP, Brasil;
,
Juliana V. Souza Framil
1   Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Doenças Infecciosas, São Paulo SP, Brasil;
,
Augusto Penalva de Oliveira
2   Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Neurologia, São Paulo SP, Brasil;
,
José E. Vidal
2   Instituto Emílio Ribas de Doenças Infecciosas, Departamento de Neurologia, São Paulo SP, Brasil;
4   Universidade de São Paulo, Hospital das Clinicas, Divisão de Moléstias Infecciosas, São Paulo SP, Brasil;
5   Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Laboratório de Investigação Médica (LIM) 49, São Paulo SP, Brasil.
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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.

RESUMO

Meningite meningocócica (MM) é um problema de saúde pública. Os objetivos deste estudo foram descrever características clinicas de pacientes com MM, e identificar fatores associados à mortalidade intra-hospitalar. Trata-se de um estudo retrospectivo, entre 2006 e 2011, em um centro de referência, São Paulo, Brasil. Análise de regressão logística multivariada foi usada para identificar fatores associados na admissão com mortalidade intra-hospitalar. Foram incluídos 316 casos. A média de idade foi 16 anos (IQR: 7–27) e 189 (60%) eram do sexo masculino. A tríade clínica: febre, cefaléia e rigidez de nuca foi observada em 89% dos casos. A tríade do exame de líquor: pleocitose, proteinorraquia elevada e hipoglicorraquia ocorreu em 79% dos casos. Fatores associados à mortalidade no modelo multivariado foram: idade acima de 50 anos, convulsões, taquicardia, hipotensão e rigidez de nuca. Tríades clínicas e laboratoriais clássicas de MM foram variáveis. Na admissão, idade, convulsões, taquicardia e hipotensão associaram-se independentemente com o desfecho.

meningitis, meningococcal - Neisseria meningitidis - epidemiology
meningite meningocócica - Neisseria meningitidis - epidemiologia

This study was presented at the XVI Pan American Congress of Infectious Diseases. Santiago de Chile, Chile 2013. Oral presentation No. 58.




Publication History

Received: 16 June 2016

Accepted: 19 July 2016

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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