[The clinical picture, treatment and prognosis of meningitis due to anaerobic and nonfermentative bacteria].

OBJECTIVES

The study of incidence, clinical manifestations and prognosis of meningitis with anaerobic and non-fermentative bacteria.

MATERIAL AND METHOD

Retrospective study of 10 patients with severe forms of purulent meningitis admitted in the Hospital of Infectious Diseases of Iaşi, during 1.01.1990-31.12.1998.

RESULTS

3 of them were diagnosed with etiology with polymicrobial flora and the rest had etiology with: Peptostreptococcus (2 cases), Acinetobacter calcoaceticus (4 cases), Eikenella corrodens (1 case). The majority were male sex (8 cases), and from rural area (9 cases). The age of patients ranged from 2.5 to 59 years (the majority being adults of group of age 50-60 years). The gate of entrance was: iatrogenic in the majority of cases (6 cases), posttraumatic (2 cases) and othogen (2 cases); 3 cases being with cerebrospinal fluid fistula and 8 patients being in coma. The factors associated with poor prognosis were: the immunosuppression (chronic etilism--4 cases; bronchopneumonia--2 cases, pulmonary cancer--1 case) and the presence of the focal neurological findings on the noser of illness. The diagnosis was established by clinical characters and confirmed by isolating germs from cerebrospinal fluid. The treatment was done at the beginning with first intervention antibiotic association with a high spectrum and then according to the antibiogramme. The evolution was severe even under treatment with 3 deaths, the mortality being of 30.0%.

CONCLUSIONS

We wished to present these cases as a general remark on the severity of illness, generally appeared on a suppressed ground, together with the rarity of those germs implicated in the etiology of purulent meningitis.