Clinical laboratory features of meningococcal infection, meningitis and meningoencephalitis of other etiology

• Vildan K. Fazylov
• Tkacheva Svetlana V.
• Nail F. Drozdova

Abstract

Meningococcal infection (MI) is one of life threatening and unpredictable by speed of development infectious diseases, wide spread all over the world. MI requires special approach to organization of diagnostics and urgent medical care due to high mortality of generalized forms if the treatment is delayed.

Aim – find out specific features of morbidity, clinical course of meningococcal infection, meningitis and meningoencephalitis of other etiology based on clinical epidemiological and laboratory diagnostics according to the data of Republican Clinical Infectious Hospital MH RT named after A.F. Agafonov of 2010–2014 years.

Results. Among hospitalized to the ICU RCIH 85 patients the majority were men (55%) aged 21 to 30 years old with bacterial (purulent), including meningococcal meningitis and meningoencephalitis (62.4%). The course of meningococcal infection was in 2 clinical forms: meningitis/meningoencephalitis (55%) and also mixed form (meningitis/meningoencephalitis combined with meningococcemia). The most informative method of specific diagnostics of MI (mixed form) was spinal fluid analysis with cultural and PCR methods with provisional use of express-tests (bacterioscopy and latex-test) (65% of positive results). Etiologic factor for bacterial (purulent) meningitis and meningoencephalitis in 45.5% of patients was Str. рneumonia. In 50% of hospitalized patients with serous meningitis, meningoencephalitis etiology remained unclear, in 12.5% enterovirus was found in spinal fluid, in 9% of patients cytomegalovirus and HSV 1, 2 type were found.

Conclusions. Among hospitalized patients 62.4% were with bacterial (purulent) meningitis/meningoencephalitis, of which 24% meningococcal etiology. Generalized clinical forms of MI – meningitis/meningoencephalitis prevailed (55%). Mixed forms of MI in 63% of patients were complicated by development of toxic shock 1–3 degree. More than 45% of bacterial (purulent) meningitis and meningoencephalitis had pneumococcal etiology. Mortality rate among hospitalized patients was 8% and was associated with bacterial (pneumococcus, klebsiella, Escherichia coli) meningitis/meningoencephalitis.

Keywords:meningococcal infection, bacterial and serous meningitis, meningoencephalitis

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