Epidemiology of the bacterial and viral acute meningitis occurred in the Instituto Estadual de Infectologia S??o Sebasti??o (IEISS) - Rio de Janeiro

Descreve um estudo de Coorte Descritivo Retrospectivo, realizado com dados obtidos atrav??s de prontu??rios de pacientes internados no Instituto Estadual de Infectologia S??o Sebasti??o, no per??odo de 11/96 a 06/97, que tiveram diagn??stico definitivo de meningite bacteriana ou viral. Procedeu-se ??s estimativas das gravidade e letalidade, de ambas as meningites, comparando-as entre si, bem como dos respectivos agentes etiol??gicos espec??ficos. Com base nos 204 pacientes, 141 dos quais, portadores de meningite bacteriana e 63, de meningite viral, viu-se que as primeiras se apresentaram mais graves e mais letais que estas ??ltimas, com excessos de risco de 17,6 e 7,8 por cento, respectivamente. Tamb??m evidenciou-se que, apesar de todas as infec????es bacterianas apresentarem casos graves e incid??ncia de ??bitos, a que teve maior n??mero destes desfechos foi a meningite pneumoc??cica, enquanto que, dentre as virais, a meningite por Herpes simples v??rus, foi a ??nica a apresentar tais eventos. Os maiores preditores para a gravidade foram a meningite pneumoc??cica, a meningite por Herpes simples v??rus e a idade de 15 anos ou mais. J?? para a letalidade, os preditores, al??m destes pat??genos, foram os menores de 1 ano e evolu????o cl??nica para o coma, na meningite bacteriana, e a idade de 15 anos ou mais e evolu????o para torpor ou coma na viral. Ainda constatou-se que as caracter??sticas liqu??ricas seguem um padr??o bem definido para cada uma das meningites em estudo.This is a Retrospective Descriptive Cohort study, accomplished through reference book, with patients interned at the S??o Sebasti??o State Institute of Infectology, in Rio de Janeiro City, Brazil, in the period from 11/96 to 06/97, with definitive diagnosis of bacterial or viral meningitis. It was proceeded to the estimates of the severity and mortality, of both meningitis, comparing them to each other, as well as the respective pathogens. Based on the 204 patients, 141 of the which, carriers of bacterial meningitis and 63, of viral meningitis, the first ones came more severe and more lethal than these last ones, with excesses of risk of 17,6 and 7,8%, respectively. It was also evidenced that, in spite of all the bacterial infections they present severe cases and obits incidence, the one that had larger number of these was the pneumococcal meningitis, while, of the viral ones, the meningitis for Herpes simplex virus, was the only to present such events. The most importants predictores for the severity were pneumococcal meningitis, herpes simplex virus meningitis and the 15 years-old age or more. Already for the mortality, the predictores, besides these pathogens, was last then 1 year old and clinical evolution for the coma, in the bacterial meningitis, and the 15 years-old age or more and evolution for torpor or coma, in the viral one. It was still verified that the cerebrospinal fluid (CSF) characteristic follows a pattern very defined for each one of the meningitis in study