Some of the meningococcal meningitis in Qatar: epidemiology, clinical and laboratory features

ABSTRACT

To define the demographic, clinical and laboratory features, methods of diagnosis and outcome, in patients with meningococcal meningitis in Qatar, records were reviewed retrospectively to 25 patients [21 male, 4 female; mean age 24 years] treated for meningococcal meningitis at the Hamad Medical Corporation [HMC] between 1 992 and 2008]. Most [88%] were expatriates. The most common presenting symptoms were fever, vomiting, headache and altered consciousness. Neck stiffness and impaired level of consciousness were the most common signs. Elevated WBC, elevated protein and low glucose in CSF were present in 95.6%, 84% and 80% of cases respectively. Positive CSF Grain-stain showing gram negative diplococci and culture growing N. meningitidis in CSF and blood were seen in 64%, 44% and 7 2.7% of cases respectively. The most common serotypes were Groups A and W 1 35 accounting for 50% and 25% respectively. 1 5.8% of isolates were intermediately resistant to penicillin, while all were sensitive to ceftriaxone. One patient [4%] died and 24 [96%] survived. Six of those who survived developed neurologic sequelae. Meningococcal meningitis remains uncommon in Qatar but the incidence has increased markedly recently especially among expatriates. Because the clinical features of the disease are non-specific, a high index of suspicion is essential for early diagnosis. Empirical treatment with ceftriaxone in a patient with suspected meningococcal meningitis seems prudent to avoid an unfavorable outcome: