Soumaré M, Seydi M, Ndour C T, Fall N, Dieng Y, Sow A I, Diop B M
Clinique des maladies infectieuses, CHU de Fann, BP 5035 Dakar, Sénégal.
Med Mal Infect. 2005 Jul-Aug;35(7-8):383-9. doi: 10.1016/j.medmal.2005.03.009.
This retrospective study was carried out to determine the prevalence of cerebromeningeal diseases at the Fann Teaching Hospital Infectious Diseases Clinic, in Dakar, and to describe their epidemiological, clinical, and etiological features.
Data was collected for analysis from patients files recorded from January 1, 2001 to December 31, 2003.
Four hundred seventy cases were identified (11.4% of total admissions) with a M/F sex ratio of 1.38 and a mean age of 33 years. Eighty-nine patients were infected by HIV and clinical presentations included fever (78%), meningeal syndrome (57.4%), coma (64.9%), convulsions (19%), focal neurological deficits (15.5%), and cranial nerves dysfunction (7.2%). Etiologies presented as cerebral malaria (85 cases), purulent meningitis (51 cases), neuromeningeal cryptococcosis (37 cases), tuberculous meningitis (11 cases), intracranial abscess (10 cases), toxoplasma encephalitis (4 cases), cerebrovascular attack (11 cases), and cerebromeningeal hemorrhages (3 cases). In as many as 248 cases (52.8%) no etiology could be found. The case fatality rate was 44.5% overall (209 deaths) and 68.5% among HIV-infected patients. Neurological sequels were found in 22 survivors (8.8%), consisting in focal neurological deficit (12 cases), deafness (5 cases), diplopia (2 cases), dementia (2 cases), postmeningitic encephalitis (1 case).
These results show the need to improve our technical capacities in our diagnostic laboratories, the prevention of opportunistic infections in the course of HIV/AIDS infection, and the involvement of various specialists in the management of cerebromeningeal diseases.
本回顾性研究旨在确定达喀尔法恩教学医院传染病诊所脑膜疾病的患病率，并描述其流行病学、临床和病因学特征。
收集了2001年1月1日至2003年12月31日记录的患者档案数据进行分析。
共确诊470例（占总入院人数的11.4%），男女比例为1.38，平均年龄33岁。89例患者感染了艾滋病毒，临床表现包括发热（78%）、脑膜综合征（57.4%）、昏迷（64.9%）、抽搐（19%）、局灶性神经功能缺损（15.5%）和脑神经功能障碍（7.2%）。病因包括脑型疟疾（85例）、化脓性脑膜炎（51例）、神经脑膜隐球菌病（37例）、结核性脑膜炎（11例）、颅内脓肿（10例）、弓形虫脑炎（4例）、脑血管意外（11例）和脑膜脑出血（3例）。多达248例（52.8%）病例未发现病因。总体病死率为44.5%（209例死亡），艾滋病毒感染患者中为68.
