[Prognostic factors in bacterial meningitis in adults. Retrospective analysis of 46 patients].

Clinical and laboratory data on 46 patients with acute bacterial meningitis were analyzed in a retrospective survey. The incidence of bacterial meningitis in hospital admissions was 1.3% and the mortality 33%. Streptococcus pneumoniae was the most frequent etiologic agent. Mortality was highest for pneumococcal meningitis and was higher in patients over 50 years of age (83% vs 25%, p less than 0.05). The initial stage of consciousness was prognostically important. All awake patients survived, while the more impaired the consciousness (from lethargy to coma), the higher the mortality (19%, 25%, and 78% respectively). Seizures and paresis of the third cranial nerve were significantly higher in lethal cases. Brain edema was the leading cause of death (60%). The interval between hospital admission and start of antibiotic treatment was crucial for prognosis. Patients who received the first dose of antibiotics within 3 hours after admission had a mortality of 13%, while a delay of 6-24 hours increased the mortality to 3/3.