[Bacterial CNS infections in adults in Southern Lower Saxony. A retrospective study of the Göttingen Neurologic University Clinic].

All 155 patients with suspected bacterial central nervous system (CNS) infections treated from 1986 to 1991 at the Department of Neurology, University of Göttingen, were evaluated in a retrospective study. According to the clinical symptoms presented at admission, 7 cases were classified as encephalitis, 44 as meningitis, 15 as radiculitis, 19 as ventriculitis, 61 as meningoencephalitis and 9 as meningoradiculitis. In 78% of these cases, the causative bacteria were either isolated from cerebrospinal fluid (CSF), or other relevant sources (blood, wound swabs) or identified by serological methods; (all cases of CNS borreliosis, and 3 of the 5 cases of listeriosis were identified by means of the last mentioned method). CNS infections caused by staphylococci and Borrelia burgdorferi were most frequent, followed by those due to pneumococci, meningococci and other streptococci. CNS infections caused by Mycobacterium tuberculosis, Listeria monocytogenes, Haemophilus influenzae and enterobacteriaceae were less frequent. In comparison to the CNS infections due to other bacteria, the pneumococcal and meningococcal meningitic infections were associated with more pronounced CSF alterations (on the average, there were higher white blood cell counts, and higher CSF protein and lactate). Pneumococci predominated in older patients and those with an impaired immune system, or infections of organs neighboring the CNS. Meningococci were most frequent in young and previously healthy individuals. All patients with CNS listeriosis had predisposing conditions. Meningococcal meningitis was either fatal or resolved with or without minimal neurological deficits. Infections caused by staphylococci or pneumococci were associated with a high percentage of neurologic sequelae.