Management, complications, and outcome of 100 cases of meningococcal meningitis in Gezira state, Central Sudan in 1999

ABSTRACT

To determine the serogroup of the meningococcus responsible for the epidemic that occurred in Wad Medani Central Sudan in 1999; to show the effectiveness of a combination therapy of a single dose of chloramphenicol with crystalline penicillin in the management; and to determine complications which occurred at that particular time. Patients and 100 patients suspected of having meningococcal meningitis were included in the study. Thorough history and physical examinations including CSF examination were done on all patients. The CSF was examined with Gram stain, culture, and serogrouping. All patients received a single dose of 3 g of chloramphenicol and crystalline penicillin 3 mega units 6 hourly IV for 5 days. The age ranged between 15 to 65 years, and there were 64 males and 36 females. The CSF was turbid in 80% of the cases and under high pressure in 95%. Fifteen cases showed Neisseria meningitides Group A when cultured. By the 5th day of treatment, most of the patients had recovered completely. Complications included death [2 patients], arthritis, deafness, and deterioration in vision. Neisseria meningitides Group A was responsible for the epidemic. Chloramphenicol with crystalline penicillin was an effective treatment. Monoarticular arthritis was the most common complication with the knee joint being the most frequently affected