Contribution of the syndromic approach in the diagnosis of meningitis at the university hospital of Marrakech

Abstract

Introduction: central nervous system (CNS) infections such as meningitis and encephalitis currently represent a real diagnostic and therapeutic challenge. The objective of this study is to evaluate the contribution of the syndromic approach in the rapid and targeted diagnosis of meningitis and meningoencephalitis at the University Hospital of Marrakech. Methods: this is a prospective study conducted over a period of one year (February 2018 - February 2019), including all patients with lumbar puncture with a cytology greater than 5 elements/mm3 and patients admitted for suspicion of meningoencephalitis. Results: during this period, 176 lumbar punctures were performed that met the criteria to multiplex PCR, 101 cases for suspicion of meningo-encephalitis and 75 cases for suspicion of meningitis. The etiology was confirmed in 23% of the LCS treated for suspicion of meningitis. Bacterial etiology dominated the pattern in 70.5% of cases followed by viral (23.5%) and fungal (6%) etiology. The etiology was confirmed in 14% of the LCS treated for suspicion of meningoencephalitis. Viral etiology dominated the pattern in 81% of cases followed by bacterial (12.5%) and fungal (6%) etiology. Conclusion: their rapid and efficient diagnosis made it possible to set up an appropriate treatment by avoiding the unnecessary prescription of antibiotics

Keywords

• meningitis
• encephalitis
• multiplex pcr