Open AccessDiagnostic and mortality outcomes in a cohort of adult meningitis suspects in KwaZulu-Natal
Author(s) -
Onke kala,
Colleen Aldous,
Douglas Wilson
Publication year - 2018
Publication title -
southern african journal of infectious diseases
Language(s) - English
Resource type - Journals
eISSN - 2313-1810
pISSN - 2312-0053
DOI - 10.4102/sajid.v33i1.28
Subject(s) - medicine , interquartile range , meningitis , cohort , pediatrics , pneumonia , lumbar puncture , retrospective cohort study , tuberculosis , odds ratio , cerebrospinal fluid , pathology
Background: The clinical value of lumbar puncture (LP) in settings with a high human immunodeficiency virus (HIV) prevalence has not been well defined.Methods: We performed a retrospective chart review in 394 adults undergoing LP at a single regional level public-sector hospital in KwaZulu-Natal, South Africa.Results: The median age of all the participants was 32.8 years (interquartile range 26.7; 41.2). Two hundred and fifty-five participants (64.7%) had an abnormal cerebrospinal fluid (CSF) analysis; 202 (79.5%) of whom were HIV seropositive. Sixty-four (25.1%) were diagnosed with tuberculosis meningitis and 62 (24.3%) tested positive for cryptococcal antigen. Thirty-three specimens grew Cryptococcus neoformans (32 tested antigen positive) and Streptococcus pneumonia was isolated in three specimens (0.8%). An abnormal CSF result was associated with increased risk of inpatient death (OR 3.8 [95% CI 1.7; 9.6]; p-value = 0.0004)Conclusions: CSF abnormalities were common in this cohort of adults with suspected meningitis in KwaZulu-Natal, and were associated with increased odds of mortality in hospitalised participants.