Etiology and outcome of adult bacterial meningitis in Yaoundé, Cameroon

AbstractObjective: To determine the etiology and outcome of adult bacterial meningitis in Yaoundé, Cameroon.Methods: Adult patients admitted for bacterial meningitis into the Yaoundé Central Hospital between January 1988 and December 1993 were included in a retrospective review. Patient records were examined and information regarding etiology and outcome and relevant clinical and laboratory data were collected.Results: Seventy patients were included in the study. There were 41 men and 29 women; their ages ranged from 15 to 65 years. Thirty patients had received antibiotic treatment before admission. Bacteriologic analysis of cerebrospinal fluid was performed in 46 patients, and a microbial etiology was established in 24 patients (34.3% of total). Streptococcus pneumoniae and Neisseria meningitidis, were the most common organisms. Other isolates included Escherichia coli, Salmonella enteritidis, Listeria monocytogenes, and Mycobacteria species; each of these species caused a single case of meningitis. Thirty patients (42.9%) had a complete clinical recovery, 18 patients (25.7%) developed sequelae, and 19 patients (27.1%) died. Ten patients died within 72 hours of admission. Three patients were taken out of the hospital by their families and were lost to follow-up. An age greater than 50 years was significantly associated with death (P < 0.05). Mortality was not related to etiology, although there was a trend toward increased mortality with pneumococcal meningitis.Conclusion: The authors recommend that empirical treatment for bacterial meningitis should be given promptly and should cover S. pneumoniae and N. meningitidis, which are the most prevalent causes of bacterial meningitis in the community studied