Abuhayyeh Husam A, Al Droubi Belal M, Al-Nusair Jowan M, Malkawi Bashar M, Haddad Lana K, Abed Alfattah Nour M, Abu Ghaida Jamaledin H
Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, JOR.
Department of Anatomy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, JOR.
Cureus. 2022 Oct 3;14(10):e29864. doi: 10.7759/cureus.29864. eCollection 2022 Oct.
Background This study aims to evaluate the clinical features, laboratory findings, and outcomes of children and adults diagnosed with meningitis in Jordan. Methodology This is a retrospective chart review study that targeted patients diagnosed with meningitis at King Abdullah University Hospital, a tertiary care center in Northern Jordan, from March 21, 2015, to March 31, 2019. Patients were included in this study if they were older than 28 days and had no risk factors for meningitis. Results A total of 169 patients met the inclusion criteria. Males were overrepresented (67%) and were significantly younger than females (6 vs. 17 years, p = 0.01). Positive meningeal signs were not predictive of greater cerebrospinal fluid leukocytosis (p = 0.348), and they did not provide sufficient sensitivity to be used as screening tools. The most common etiology was aseptic (49%), followed by enterovirus (43%), while bacterial meningitis was an uncommon diagnosis (3.5%). Nearly half of the patients took antibiotics prior to their hospital presentation. During in-hospital admission, six patients died, four of whom had bacterial and two had aseptic meningitis. Enteroviral meningitis showed neutrophil predominance in 44% of cases on lumbar puncture and had a higher neutrophil proportion compared to aseptic meningitis (p = 0.026). was the most common bacterial etiology identified. Conclusions Meningitis in Jordan is most commonly of aseptic and enteroviral origin, and these etiologies carry significantly more favorable outcomes compared to bacterial meningitis. Enteroviral meningitis displays a higher percentage of neutrophils in cerebrospinal fluid compared to aseptic meningitis. is the leading cause of bacterial meningitis. Slight neutrophil predominance above half is a weak predictor of bacterial meningitis due to the small contribution of bacteria as a cause among enteroviruses and aseptic etiologies.
背景 本研究旨在评估约旦诊断为脑膜炎的儿童和成人的临床特征、实验室检查结果及预后。方法 这是一项回顾性病历审查研究，研究对象为2015年3月21日至2019年3月31日期间在约旦北部三级医疗中心阿卜杜拉国王大学医院被诊断为脑膜炎的患者。年龄超过28天且无脑膜炎危险因素的患者纳入本研究。结果 共有169例患者符合纳入标准。男性占比过高（67%），且明显比女性年轻（6岁对17岁，p = 0.01）。脑膜刺激征阳性并不能预测脑脊液白细胞增多更明显（p = 0.348），且其作为筛查工具的敏感性不足。最常见的病因是无菌性（49%），其次是肠道病毒（43%），而细菌性脑膜炎是一种不常见的诊断（3.5%）。近一半的患者在入院前使用过抗生素。住院期间，6例患者死亡，其中4例为细菌性脑膜炎，2例为无菌性脑膜炎。肠道病毒性脑膜炎在腰椎穿刺时44%的病例中以中性粒细胞为主，与无菌性脑膜炎相比中性粒细胞比例更高（p = 0.026）。 是确定的最常见细菌病因。结论 约旦的脑膜炎最常见的病因是无菌性和肠道病毒性，与细菌性脑膜炎相比，这些病因的预后明显更好。与无菌性脑膜炎相比，肠道病毒性脑膜炎脑脊液中中性粒细胞的比例更高。 是细菌性脑膜炎的主要病因。由于在肠道病毒和无菌性病因中细菌作为病因的贡献较小，中性粒细胞略占半数以上是细菌性脑膜炎的弱预测指标。
