The association between serum sodium levels and tuberculous meningitis compared to viral and bacterial meningitis: Multicenter retrospective cohort study

2021 ◽  
Author(s):  
Seunghee Na ◽  
Taewon Kim ◽  
In-Uk Song ◽  
Sung-Woo Chung ◽  
Seong-Hoon Kim ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Bacterial Meningitis ◽  
Tuberculous Meningitis ◽  
Serum Sodium ◽  
Retrospective Cohort ◽  
Total Population ◽  
Viral Meningitis ◽  
Lower Serum ◽  
Cross Sectional ◽  
Additional Information

Abstract We evaluated the association between hyponatremia and tuberculous meningitis (TBM) in hopes of providing additional information for the differential diagnosis of TBM from other types of infectious meningitis, especially from viral meningitis (VM). Cross-sectional and longitudinal data involving 5,026 participants more than 18 years of age were analyzed in the total population and the propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, VM, and bacterial meningitis (BM) patients were compared. The initial serum sodium levels were significantly lower in the TBM patients than in the VM and BM patients (136.9 ± 5.9 vs. 139.0 ± 3.1, p < 0.001 for TBM vs. VM, and 138.3 ± 4.7 mmol/L and p < 0.001 for TBM vs. BM) and it dropped significantly more steeply to lower levels in both the TBM and BM patients compared to the VM patients. Consequently, the lowest serum sodium levels were in the order of the TBM < BM < VM patients, which were also statistically significant in all subgroups. (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). The participants with lower serum sodium levels were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium levels than the initial sodium levels (OR 8.4 (95% CI: 4.5–15.8, p < 0.001)). The baseline and longitudinal evaluation of serum sodium levels can provide supportive information for the differential diagnosis of TBM from VM or BM.

scholarly journals The association between serum sodium level and tuberculous meningitis compared with viral and bacterial meningitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seunghee Na ◽  
Taewon Kim ◽  
In-Uk Song ◽  
Sung-Woo Chung ◽  
Seong-Hoon Kim ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Bacterial Meningitis ◽  
Tuberculous Meningitis ◽  
Serum Sodium ◽  
Sodium Level ◽  
Total Population ◽  
Serum Sodium Level ◽  
Viral Meningitis ◽  
Cross Sectional ◽  
Additional Information

AbstractWe evaluated the association between hyponatremia and tuberculous meningitis (TBM) with the aim of providing additional information for differential diagnosis from other types of infectious meningitis, especially viral meningitis (VM). Cross-sectional and longitudinal data involving 5026 participants older than 18 years were analyzed in the total population and a propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, bacterial meningitis (BM), and VM patients were compared. Participants in the TBM group were enrolled when they were diagnosed as possible, probable, or definite TBM according to the Marais’ criteria. The initial serum sodium level was significantly lower in TBM patients than in BM and VM patients (136.9 ± 5.9 vs. 138.3 ± 4.7 mmol/L, p < 0.001 for TBM vs. BM, and 139.0 ± 3.1, p < 0.001 for TBM vs. VM), and it decreased significantly more steeply to lower levels in both the TBM and BM patients compared with VM patients. The lowest serum sodium level was in the order of TBM < BM < VM patients, and the change was statistically significant in all subgroups (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). Participants with lower serum sodium level were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium level than the initial sodium level [OR 4.6 (95% CI 2.4–8.8, p < 0.001)]. These findings indicate that baseline and longitudinal evaluation of serum sodium level can provide information for differential diagnosis of TBM from BM or VM.

scholarly journals Meningitis: etiological and outcome panorama in Brazil in the 2019-2020 biennium

2021 ◽  
Author(s):  
Saulo Azeredo ◽  
Emanuel Kerber, Yasmynni Escher ◽  
Artur Martio ◽  
Victor Angeliero
Keyword(s):  
Bacterial Meningitis ◽  
Epidemiological Study ◽  
Hospital Discharge ◽  
Absolute Number ◽  
Viral Meningitis ◽  
Cross Sectional ◽  
Mandatory Notification ◽  
The Absolute ◽  
The University

Background: Meningitis is the inflammation of the meninges. The outcome varies between etiologies. It is endemic in Brazil with mandatory notification. Objectives: To analyze the number of diagnoses and outcomes of meningitis in Brazil in the 2019-2020 biennium. Design and setting: Cross-sectional epidemiological study using DATASUS database realized by Neurology department of the University of Passo Fundo. Methods: Data from patients diagnosed with meningitis in the period from 2019 to 2020 were included, correlating them to the etiologies and their outcomes. Results: There was a 70.8% reduction in the absolute number of diagnosed meningitis in 2020 (4,713) compared to 2019 (16,155). The most prevalent specified cause was “viral meningitis”, corresponding to 49,1% in 2019 and 42% in 2020. There was no great variation in the percentage of etiologies. “Hospital discharge”, corresponding to 76.8% in 2019 and 68% in 2020. “Death” was the outcome of 14.8% of patients in 2020 and 12.9% in 2019. The most related option to “Death from meningitis” was “Bacterial meningitis”, responsible for 24% in 2020 and 21.3% in 2019. Conclusions: The number of diagnoses of meningitis fell in the 2019-2020 comparison. The context of under-diagnosis worries because it means late diagnoses and worse outcomes.

scholarly journals Role of procalcitonin in viral and bacterial meningitis

2021 ◽  
Vol 8 (7) ◽  
pp. 947
Author(s):  
Nipun Saproo ◽  
Roma Singh
Keyword(s):  
Bacterial Meningitis ◽  
Cross Sectional Study ◽  
Viral Meningitis ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Fluid Analysis ◽  
Bacteriological Profile ◽  
Clinical Presentations ◽  
Meningitis In Children ◽  
One Year

Background: Meningitis is one of the most common central nervous system infections by bacteria, virus or fungus encountered in infants and children.Early diagnosis of meningitis and differentiation of bacterial from non-bacterial/ viral meningitis tends to play an important role in the emergency management of children with suspected meningitis. While cerebrospinal fluid analysis is popular, along with biomarkers: C-reactive protein and white blood cell count, serum procalcitonin seems to offer an even better specificity.Methods: A hospital based cross-sectional-study was conducted in department of neurology in collaboration with department of pathology, Medanta, Medicity, Gurugram, for a period of one year from March 2018 to 2019. 100 children aged 4 months to 12 years, with suspected meningitis were enrolled. The study group was further subdivided into two groups, based upon their bacteriological profile: bacterial meningitis and viral meningitis.Results: For both the groups, the common clinical presentations were fever (100% and 96.88%), convulsions (58.33% and 45.31%), vomiting (25% and 43.75%), The demographic and clinical profile of the 2 groups was largely comparable. Serum PCT levels were significantly higher in bacterial meningitis group compared to non-bacterial meningitis with p<0.001. The sensitivity of serum PCT was found to be 97% and superior to CRP in terms of accuracy in identification and to assess the severity. Procalcitonin is an ideal marker with highest accuracy for bacterial infections.Conclusions: Serum PCT can act as a more sensitive and specific diagnostic tool in early differentiation of bacterial from non-bacterial meningitis in children.

scholarly journals Comparison of Laboratory Profiles of Cerebrospinal Fluid among Bacterial and Viral Meningitis Patients

2021 ◽  
Vol 7 (1) ◽  
pp. 69-74
Author(s):  
Umme Habiba ◽  
Md Akram Hossain ◽  
Md Chand Mahmud ◽  
Md Sirajul Islam Bhuiyan ◽  
Md Ali Abdullah Rafique ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Cross Sectional Study ◽  
Viral Meningitis ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
Medical College ◽  
The Mean ◽  
Wbc Count ◽  
Physical Findings

Background: Laboratory profiles are important markers for the detection of meningitis. Objective: The purpose of the present study was to compare of laboratory profiles of cerebrospinal fluid among bacterial and viral meningitis patients. Methodology: This cross sectional study was carried out in the Department of Microbiology at Mymensingh Medical College, Mymensingh, Bangladesh from July 2010 to January 2012 for around 2 years. Clinically suspected patients with meningitis from paediatrics wards of MMCH, Mymensingh, Bangladesh were included in this study. On the basis of cytological tests and biochemical tests of CSF the study subjects were categorized into three groups, which were identified as bacterial meningitis, viral meningitis and normal CSF. After collection of CSF, physical examination, routine bed side culture and appropriate biochemical tests were performed. Tests for protein and glucose of CSF specimens were performed. Result: A total 115 clinically and laboratory confirmed meningitis patients were enrolled in this study. The most of the cases of study population were in the age group 1 month to 5 years 97(84.3%) cases. Regarding the physical findings of CSF, purulent was found 21(60.0%) cases in bacterial meningitis and 14 (40.0%) cases were slightly turbid. The mean with SD of total count of WBC was higher in bacterial meningitis (1623.1±1708.06/mm3) than viral meningitis (56.0±73.83/mm3) (p=<0.001). Again the mean with SD of glucose was lowest in bacterial meningitis which was 21.0±9.77 mg/dL followed by viral meningitis which was 63.6±20.22 mg/dL. (p<0.001). Considering protein of CSF the mean with SD was highest in bacterial meningitis which was 242.8±188.09 mg/dL followed by viral meningitis which was 69.6±84.67mg/dL (p<0.001). Conclusion: In conclusion the WBC count, CSF glucose and protein are significantly differ in bacterial and viral meningitis. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 69-74

scholarly journals Spectrum of central nervous system infections in neurosciences hospital in two years : a retrospective study

2020 ◽  
Vol 16 (1) ◽  
pp. 67-73
Author(s):  
Aiyar Shakir Jawad
Keyword(s):  
Spinal Cord ◽  
Bacterial Meningitis ◽  
Tuberculous Meningitis ◽  
Viral Encephalitis ◽  
Viral Meningitis ◽  
Preschool Age ◽  
Clinical Aspects ◽  
High Morbidity ◽  
Focal Neurological Deficit ◽  
Cns Infections

Background :Infectious disorders in general have high morbidity and mortality.. CNS infections include many disorders like bacterial meningitis, tuberculous and other subacute and chronic meningitis, viral meningitis, cerebral abscess, spinal cord infections, and others.Objective: To assess our locality about prevalence of CNS infections , to have more awareness regarding CNS infections, and to try to find the proper way to reduce their prevalence and to treat them in appropriate way.Method :We revised the records of all the cases of CNS infections excluding cases of spinal cord infections who were admitted in the wards of neuroscience hospital over the previous two years ( from July/2010 to June 2012 ),those were 132 cases.Seasonal incidenceand other clinical aspects and other parameters like age , sex, , fever are extracted and recordedResults: The most common CNS infections in sequence from the most to the least were bacterial meningitis, viral encephalitis, tuberculous meningitis, viral meningitis, and cerebral abscess.The most common age group which is affected by CNS infections was below 10 years.Males are affected more than females taking in consideration all types of infection.P values were statistically significant for age, fever, signs of meningeal irritation, focal neurological deficit, and seizures.Conclusion : The total rate of admission of CNS infections in our series was lower than other study.The most frequent type of CNS infections was bacterial meningitis which is the same as most of the studies.Males are affected more than females in our study in all types of CNS infections, this was approximate to other studies except for tuberculous meningitis.Bacterial meningitis and viral encephalitis were more common in preschool children in our study.Fever rate in bacterial and tuberculous meningitis was different from other studies.Seizure rate in bacterial meningitis and viral encephalitis was approximate to other results.Rate of focal deficit in viral encephalitis and tuberculous meningitis was different from other studies.Rate of CSF protein elevation in all CNS infections was approximate to other studies.Rate of hypoglycorrhachia was different from other studies only in tuberculous meningitis.CSF pleocytosis was approximate to other studies in all types of CNS infections.The two most common types of CNS infections , bacterial meningitis and viral encephalitis, are more common in preschool age groups.

scholarly journals Meningitis: etiological and outcome panorama in Brazil in the 2019-2020 biennium

2021 ◽  
Author(s):  
Saulo Azeredo ◽  
Emanuel Kerber ◽  
Yasmynni Escher ◽  
Artur Martio ◽  
Victor Angeliero
Keyword(s):  
Bacterial Meningitis ◽  
Epidemiological Study ◽  
Hospital Discharge ◽  
Absolute Number ◽  
Viral Meningitis ◽  
Cross Sectional ◽  
Mandatory Notification ◽  
The Absolute

Background: Meningitis is the inflammation of the meninges. The outcome varies between etiologies. It is endemic in Brazil with mandatory notification. Objectives: To analyze the number of diagnoses and outcomes of meningitis in Brazil in the 2019-2020 biennium. Design and setting: Cross-sectional epidemiological study using DATASUS database. Methods: Data from patients diagnosed with meningitis in the period from 2019 to 2020 were included, correlating them to the etiologies and their outcomes. Results: There was a 70.8% reduction in the absolute number of diagnosed meningitis in 2020 (4,713) compared to 2019 (16,155). The most prevalent specified cause was “viral meningitis”, corresponding to 49,1% in 2019 and 42% in 2020. There was no great variation in the percentage of etiologies. “Hospital discharge”, corresponding to 76.8% in 2019 and 68% in 2020. “Death” was the outcome of 14.8% of patients in 2020 and 12.9% in 2019. The most related option to “Death from meningitis” was “Bacterial meningitis”, responsible for 24% in 2020 and 21.3% in 2019. Conclusions: The number of diagnoses of meningitis fell in the 2019-2020 comparison. The context of under-diagnosis worries because it means late diagnoses and worse outcomes.

scholarly journals Hyponatraemia in Community Acquired Bacterial and Tubercular Meningitis in Hospital Admitted Adult Patients

2014 ◽  
Vol 15 (2) ◽  
pp. 114-117
Author(s):  
Poly Sengupta ◽  
Md. Roushan Ali ◽  
Fazle Rabbi Mohammed ◽  
Rama Biswas ◽  
Mamunur Rashid ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Clinical Importance ◽  
Tubercular Meningitis ◽  
Cross Sectional ◽  
Medical College ◽  
True Prevalence ◽  
Level Of Consciousness

Background: Bacterial and Tubercular Meningitis is a life-threatening disease. Hyponatraemia in bacterial and tubercular meningitis is a known complication with unknown true prevalence and clinical importance. This study was conducted to find out how commonly hyponatraemia occurs in community acquired bacterial and tubercular meningitis, to evaluate its severity, to see the pattern of presentation and to observe the level of consciousness. Materials and Methods: It was a descriptive cross sectional study performed in 30 admitted patients with clinically diagnosed bacterial and tubercular meningitis in medicine wards of Medical College for Women & Hospital (MCWH) and Dhaka Medical College & Hospital (DMCH) since August 2009 to March 2010. Serum electrolyte and level of consciousness on admission was recorded in all patients. Results: Twenty Nine patients (96.7%) with meningitis had hyponatraemia, serum sodium level ranged from 115-138 mmol/l; mean sodium level is 128.57 ± 5.56 SD mmol/L. Serum sodium level was mild (>125-135 mmol/L) in 20 (66.7%) patients with meningitis and moderate (110-125 mmol/L) in 9 (30%) and severe (<110 mmol/L) in 1 (3.3%) patient. GCS ranged from 8 to 14, mean 11.56±1.40 SD in day 1. In tubercular meningitis (n=8) and bacterial meningitis (n=22) serum sodium level was 128.63±7.44 and 128.55±4.93 while mean GCS was 11.38±2.13 and 11.95±1.40 respectively on the day of admission. Conclusion: Although the true prevalence, severity and clinical importance of hyponatraemia in bacterial meningitis are unknown, its presence may influence the outcome in such patients depending on severity. So knowledge about its prevalence and severity will guide physicians to take decisions about its management.DOI: http://dx.doi.org/10.3329/jom.v15i2.20682 J MEDICINE 2014; 15 : 114-117

scholarly journals A New Scoring System for the Differential Diagnosis between Tuberculous Meningitis and Viral Meningitis

2018 ◽  
Vol 33 (31) ◽  
Author(s):  
Sang-Ah Lee ◽  
Shin-Woo Kim ◽  
Hyun-Ha Chang ◽  
Hyejin Jung ◽  
Yoonjung Kim ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Tuberculous Meningitis ◽  
Scoring System ◽  
Viral Meningitis ◽  
New Scoring
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