Acta clinica Croatica, Vol. 56. No. 1., 2017.
Original scientific paper
https://doi.org/10.20471/acc.2017.56.01.17
Predisposing Factors Responsible for the Occurrence of Bacterial Purulent Meningoencephalitis
Brankica Dupanović
; Clinical Center of Montenegro, Podgorica, Montenegro
Olgica Gajović
; Kragujevac Clinical Center, Kragujevac
Dragica Terzić
; Clinical Center of Montenegro, Podgorica, Montenegro
Bogdanka Andrić
; Clinical Center of Montenegro, Podgorica, Montenegro
Zoran Todorović
; Kragujevac Clinical Center, Kragujevac
Branko Jakovljević
; Institute for Hygiene and Medical Ecology, School of Medicine, University of Belgrade, Belgrade, Serbia
Danko Živković
; Clinical Center of Montenegro, Podgorica, Montenegro
Abstract
Bacterial purulent meningoencephalitis (BPME) is a life-threatening infectious disease caused by various pyogenic bacteria. The disease is defined as the inflammatory process of leptomeninges (visceral layer, pia mater and arachnoid membrane) and brain parenchyma with exudates in the subarachnoid space and surrounding brain structures. The aim of the study was to define the predisposing factors responsible for the occurrence of BPME, as well as the possible correlation between the presence of predisposing factors and patient demographic characteristics, etiology and outcome of the disease. This retrospective-prospective study included 90 patients with BPME confirmed by clinical, neuroradiological and laboratory findings. Multivariate logistic regression models were fitted to analyze the impact of the predisposing factors on the disease outcomes. Predisposing factors that were related to BPME were found in 61% of patients. Cranial trauma as the leading factor was recorded in 23.3% of patients, followed by previous neurological disease in 14.4% of patients, while 13 patients were exposed to previous chemotherapy or long-term corticosteroid therapy. Cardiovascular diseases were reported in 12.2% and diabetes in 7.8% of patients. The existence of cardiovascular diseases significantly influenced unfavorable outcome of the disease, i.e. ”deceased” in comparison to ”cured” (OR=8.418; 95% CI=1.007-76.270), independently of age and gender. None of the examined predisposing factors was significantly related to the ”recovered with sequels” outcome as compared with ”cured” outcome. Older age and presence of cardiovascular disease as a predisposing factor significantly increased the odds of the BPME unfavorable outcome ”deceased” as compared to ”cured” outcome.
Keywords
Meningitis, bacterial; Meningoencephalitis; Treatment outcome; Causality
Hrčak ID:
184418
URI
Publication date:
1.3.2017.
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