The Contribution of delayed Diagnosis to the Outcome in Pyogenic Meningitis.

Abstract

Summary: Meningitis was unsuspected following initial admission work-up in 25.8 percent of 66 infants and children with pyogenic meningitis managed at the University of Maiduguri Teaching Hospital. Eleven of the 17 were infants of whom nine were aged six months and under. Diarrhoea with dehydration, pre-admission treatment with antibiotics, focal infections, malaria parasitaemia and absence of sei zures on or before admission were associated with delayed diagnosis of meningi tis. A major subsequent development which led to diagnosis was seizure which occurred in 58.8 percent of the patients; other additional developments included alteration of consciousness in 23.5 percent and appearance of signs of meningitis in 35.3 percent. Case fatality rate of 47.1 percent was higher in patients with de layed diagnosis than the 17.4 percent in those without (P = 0.024), whereas sequelae rates were comparable.