RESUMO
BACKGROUND: Although there are numerous studies on meningitis and encephalitis separately, literature on meningoencephalitis is sparse. In this study we analysed the clinical profile of meningoencephalitis and its clinical outcome. METHODS: Fifty adults diagnosed with meningoencephalitis from July 2014 to July 2015 in a tertiary care hospital in South India were studied prospectively and their clinical presentation, aetiology and outcome were analysed. RESULTS: Among 50 patients, 33 (66%) were male; 39 (78%) were <50 years of age. Fever was the most common presenting symptom in 41 out of 50 patients (82%), followed by headache (74%) and altered sensorium (62%); only 18 patients (36%) had all three classical symptoms. Twenty-eight out of 50 patients (56%) did not have neck stiffness. A majority of patients had acute-to-subacute clinical presentation. Mycobacterium tuberculosis was identified in 58% (29 out of 50). Forty-seven patients (94%) recovered completely. CONCLUSION: Tuberculosis was the most common cause of meningoencephalitis in the studied population, often with subacute presentation, and outcome was good with early institution of antituberculous therapy.
Assuntos
Anti-Infecciosos/uso terapêutico , Imageamento por Ressonância Magnética/métodos , Meningoencefalite/epidemiologia , Meningoencefalite/fisiopatologia , Adulto , Estudos de Coortes , Feminino , Febre/epidemiologia , Febre/fisiopatologia , Humanos , Índia/epidemiologia , Masculino , Meningoencefalite/tratamento farmacológico , Meningoencefalite/microbiologia , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Cervicalgia/epidemiologia , Cervicalgia/fisiopatologia , Prevalência , Prognóstico , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença , Análise de Sobrevida , Centros de Atenção Terciária , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Adulto JovemRESUMO
AIMS: Urine dipstick analysis is a quick, cheap and a useful test in predicting Urinary Tract Infection (UTI) in hospitalized patients. Our aim is to evaluate the reliability (sensitivity) of urine dipstick analysis against urine culture in the diagnosis of UTI. MATERIALS AND METHODS: Patients admitted to our hospital suspected of having UTI, with positive urine cultures were included in this study from a 2-year period (January 2011 to December 2012). Dipstick urinalysis was done using multistix 10 SG (Siemens) and clinitek advantus analyzer. The sensitivity of dipstick nitrites, leukocyte esterase and blood in these culture-positive UTI patients was calculated retrospectively. RESULTS: Urine dipstick analysis of 635 urine culture-positive patients was studied. The sensitivity of nitrite alone and leukocyte esterase alone were 23.31% and 48.5%, respectively. The sensitivity of blood alone in positive urine culture was 63.94%, which was the highest sensitivity for a single screening test. The presence of leukocyte esterase and/or blood increased the sensitivity to 72.28%. The sensitivity was found to be the highest when nitrite, leukocyte and blood were considered together. CONCLUSIONS: Nitrite test and leukocyte esterase test when used individually is not reliable to rule out UTI. Hence, symptomatic UTI patients with negative dipstick assay should be subjected to urine culture for a proper management.
