ĐẶC ĐIỂM DỊCH TỄ, LÂM SÀNG VÀ CẬN LÂM SÀNG BỆNH VIÊM MÀNG NÃO MỦ Ở NGƯỜI CAO TUỔI ĐIỀU TRỊ TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI

Abstract

Problem statement: Purulent meningitis is a serious infectious disease of the central nervous system. The disease has a high mortality rate and can leave many sequelae if not diagnosed and treated promptly. Objective: Describe the epidemiological, clinical and paraclinical characteristics of purulent meningitis in people aged 60 and over treated at the Hospital for Tropical Diseases from 2019-2023. Method: A descriptive study of a series of cases on 96 elderly patients (≥ 60 years old) with purulent meningitis admitted to the clinical departments for the treatment of adult diseases (Infection C, Infection Viet-Anh) at the Hospital for Tropical Diseases from January 2019 to October 2023. Results: Purulent meningitis in the elderly is mainly found in men (1.8 times more than women), median age 67, 89.6% have underlying diseases such as diabetes (31.3%) and corticosteroid abuse (50%); Average BMI 22.1 kg/m², 42.7% overweight/obese. Common symptoms on admission were altered consciousness (70.9%), fever (87.5%), stiff neck (86.5%), usually within 7 days. Chest X-ray showed lesions in 72.9%; head CT/MRI showed lesions in 43.4%, mainly sinusitis (30.3%) and old cerebral infarction (27.3%). 42.3% were positive for strongyloidiasis; Gram stain of cerebrospinal fluid revealed bacteria in 22.9%, cerebrospinal fluid culture was positive in 32.3%, blood culture was positive in 16.7%. The main pathogens were Gram-negative (40%) and Gram-positive (60%) bacteria, with E. coli (11.5%), S. suis (8.3%), Enterococcus spp. (7.3%), S. pneumoniae (4.2%), and K. pneumoniae (3.1%). Conclusion: Purulent meningitis in the elderly has complex characteristics with a high rate of underlying diseases, multi-organ damage and the main causative agent is bacteria from the intestinal tract.