INTERNATIONAL REPORTS Etiology and Mortality of Bacterial Meningitis in Northeastern Brazil

Little is known of the current incidence and mortality of meningitis in developing na-tions, especially in Latin America. We reviewed all cases of meningitis in an isolation-fever hospital in Salvador, Brazil, for the decade 1973-1982. Of all admissions, 6,751 (27070) were for meningitis; 4,100 (61%) of these cases were of definite or probable bacterial etiol-ogy. Children younger than 15 years accounted for 79 % of cases, and 45 % of cases were in children under 2 years. The overall case fatality rate was 33%, with 50 % of these deaths occurring within 48 hours of hospitalization. Neisseria meningitidis was the etiologic agent in 32 % ofthe cases, with a case fatality rate of 14%. Epidemics caused by N. meningitidis group C, then group A, in 1974-1978 accounted for 60 % of the cases. Streptococcuspneu-moniae caused 17 % of cases, with a case fatality rate of 59%. Haemophilusinfluenzae type b, the most common cause of nonepidemic meningitis, caused 23 % of all cases, with a case fatality rate of 38%. Enterobacteriaceae were the etiology in only 3.6 % of patients, but the case fatality rate was 86%. Cultures were negative in 18 % of cases with purulent cerebrospinal fluid. A total of 84 % of H. influenzae, 40 % of S. pneumoniae, 78 % of Enterobacteriaceae, and 15 % of N. meningitidis cases occurred in children less than