Abstract

The purpose of the study was to investigate the aetiology, risk factors, clinical symptomatology, treatment and outcome of bacterial meningitis. Using retrospective surveillance, we identified a total of 103 cases of bacterial meningitis hospitalized at North-Estonian Regional Hospital during 1999–2004. The majority of cases (30%) were caused by S. pneumoniae, followed by N. meningitidis (10%). A significant underlying illness or condition was present in 63% of the patients. Twenty-one per cent had concurrent otitis, sinusitis or mastoiditis, 8% had pulmonary pathology. CSF (cerebrospinal fluid) was cultured in 82 patients and was positive in 50 cases.
The most frequently used (in the case of 46 patients), empirical therapy, was a combination penicillin with gentamicin.
Overall mortality rate was 27%. The mortality rate was higher for patients with pneumococcal meningitis. The outcome was unfavourable in 24% of the episodes, 49% patients recovered completely. The risk factors for an unfavourable outcome were advanced age, low score on the Glasgow Coma Scale on admission and pneumococcal infection.