IV.4) PARACLINICAL INVESTIGATION
|
Table 4: Biochemical and cytological aspect of csf
analysis of patients at admission
|
|
Mean#177;SD
|
Min - max
|
|
WBC/??????
|
1181.2#177;6379.0
|
11 - 42000
|
|
Protein g/dL
|
1.30#177;1.15
|
0.1 - 5.1
|
|
Glucose g/L
|
0.49#177;0.21
|
0.16 - 1.10
|
|
RBC
|
1665.8#177;6646.5
|
1 - 36000
|
The means of the WBC were 1181.2#177;6379.0 cells/mm3 with the
minimum being 11 cells /mm3and the maximum 42000 cells /mm3. Proteins had a
mean of 1.30 #177; 1.15g/L with the minimum at 0.1 and maximum at 5.1
g/L.Glucose was 0.49#177;0.21 g/L with the minimum at 0.16 to 1.10 g/L.RBC had
a mean 1665.8#177; 6646.5 cells/mm3 with the minimum at 1 and maximum at 36000
cells/mm3.
40
Table 5: Biochemical and cytologic aspect of csf
analysis of patients at admission
|
Variable
|
Number
|
Percentage (%)
|
|
White blood cells /mm3
|
|
|
|
- [100-1000[
|
22
|
51.2
|
|
- [10-100[
|
19
|
44.2
|
|
- [1000-10000[
|
1
|
2.3
|
|
- =10000
|
1
|
2.3
|
|
-
|
|
|
|
Proteins (g/L) N=22
|
|
|
|
- <0.40
|
6
|
14.0
|
|
- 0.40 - 0.79
|
2
|
4.7
|
|
- 0.80 - 0.99
|
1
|
2.3
|
|
- =1
|
13
|
30.2
|
|
Glucose (g /L) N=22
|
|
|
|
- <0.4
|
9
|
20.9
|
|
- 0.4-0.6
|
8
|
18.6
|
|
5
|
11.6
|
|
- >0.6
|
|
|
*N=number of patients who had CSF analysis done
for both biochemistry and cytology.
The biochemical and cytologic aspects of the CSF analysis showed
in this study that most of the patients that were confirmed with meningitis had
the WBC from 101000 cells /mm3 at 95.4 %.
Then 22 patients had their CSF biochemistry done and, among them
13 had proteins =1 g/L at 30.2 % and 9 patients had glucose <0.4 g/L with a
high percentage of 20.9 %.
41
IV.5) ETIOLOGIES OF BACTERIAL MENINGITIS
N. meningitidis
4 (25%)
Group B Strep
1 (6%)
Salmonella
1 (6%)
S. pneumoniae
10 (63%)
*Culture = 6 patients
* Soluble antigen = 7 patients * Gram stain = 10
patients
*It is seen that the means of identification of
bacterium indicates more than 16 patients but it is due to the fact that a
bacterium was identified by both Gram stain and soluble antigen.
Streptococcus pneumoniae was the most predominant
bacterium isolated with 56 %, followed by Neisseria meningitidis at 33
%. Other bacteria found were Salmonella and Group-B streptococcus
each at a lower percentage of 6 %.
42
Table 6: Distribution of pathogens according to
age
|
GERM
|
[1 - 3[ month s
N (%)
|
[3 - 12[ months N (%)
|
[12 -36[ months N (%)
|
[36-60[
months
N (%)
|
=60 months N(%)
|
Total
|
|
2
|
5
|
2
|
0
|
1
|
10
|
|
S.pneumoniae
|
(15.4)
|
(35.7)
|
(25.0)
|
(0.0)
|
(16.7)
|
(23.3)
|
|
0
|
1
|
0
|
0
|
0
|
1
|
|
(0.0)
|
(7.1)
|
(0.0)
|
(0.0)
|
(0.0)
|
(2.3)
|
|
GBS
|
|
|
|
|
|
|
|
N.meningitidi
|
1
|
1
|
0
|
1
|
1
|
4
|
|
s
|
(7.7)
|
7(.1)
|
(0.0)
|
(50.0)
|
(16.7)
|
(9.3)
|
|
Salmonella
|
0
|
1
|
0
|
0
|
0
|
1
|
|
(0.0)
|
(7.1)
|
(0.0)
|
(0.0)
|
(0.0)
|
(2.3)
|
|
No culture nor soluble
antigen done
|
1
(7.7)
|
2
(14.3)
|
3
(37.5)
|
0
(0.0)
|
1
(16.7)
|
7
(16.3)
|
|
Sterile
|
9
|
4
|
3
|
1
|
3
|
20
|
|
(69.2)
|
(28.6)
|
(37.5)
|
(50.0)
|
(50.0)
|
(46.5)
|
|
13
|
14
|
8
|
2
|
6
|
43
|
|
TOTAL
|
(100.
|
(100.0
|
(100.0
|
(100.0
|
(100.0
|
(100.0
|
|
0)
|
)
|
)
|
)
|
)
|
)
|
It is seen that among the 43 cases of bacterial meningitis,
bacteria were isolated in 16 cases with a total percentage of 37.2% of patients
who did either the culture or soluble antigen for the diagnosis of bacterial
meningitis. From the 16 cases, we had Strep pneumoniae which was
higher present at 23.3 % at age range 3months to 12 months more affected.
Neisseriameningitidis follows with 9.3% and evenly distributed amongst the
age group. It should also be noted that 46.5 % of the cases had sterile CSF.
43
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