Prognostic factors of meningococcic meningitis: a study of 254 cases

Abstract

Two hundred and fifty-four cases of acute meningococcic meningitis at the hospital of the University of Londrina, Paraná (Brazil), between 1972 and 1976, were analyzed to determine the lethality of nine prognostic factors, which, according to literature, are said to aggravate the prognosis, namely: age, the period of time the patient has had the disease before admission, petechial and purpuric lesions of the skin, shock, coma, reduced number of leucocytes in peripherical blood, normal cerebrospinal fluid (c.s.f.) on admission, leucocyte number in c.s.f. lower than 100/mm³, protein concentration in c.s.f. higher than 300 mg/dl and glucose concentration in c.s.f. lower than 10 mg/dl (all in c.s.f. obtained upon admission). The following prognostic factors significantly influenced the mortality rate for this disease: 1) extreme ages - greater lethality in children under one year of age and in adults older than 40; 2) if the patient showed signs of the disease less than 48 hours before admission; 3) patient in coma upon admission, or; 4) in a state of shock; 5) leucocytes numbering 10,000/mm³ or lower in peripherical blood obtained upon admission. The combination of these factors showed that the greater the number of associated factors, the higher the mortality rate.