Evaluation of Patients Admitted to the Emergency Medicine Department with Symptoms of Central Nervous System Infection

Patients Admitted to the Emergency Medicine Department with Symptoms of Central Nervous System Infection

Abstract

Aim: We aimed to investigate the demographic data, diagnoses and predictive factors for infection in patients admitted to the emergency department with central nervous system (CNS) symptoms and signs.

Materials and Method: We retrospectively analyzed 88 cases admitted to the emergency department of a tertiary care university training and research hospital with central nervous system symptoms in terms of demographic data, examination findings, hospitalization status, cerebrospinal fluid (CSF) culture growth and mortality. The cases were analyzed in 3 groups as central nervous system infection, non-infectious central nervous system pathologies and pathologies other than central nervous system.

Results: Out of 88 patients, 17 (19.3%) had central nervous system infection. Purulent meningitis was diagnosed in 11 (64.7%) and encephalitis in 6 (35.2%) of these cases. Complaints of vomiting, CSF culture collection rate, Kernig sign positivity, nuchal rigidity and hospitalization rate were significantly higher in the CNS infection group compared to the other two groups. There was no difference between the groups in terms of mortality. In cases of purulent meningitis, CSF cultures were collected from 9 of 11 patients and growth was observed in 2 samples (22.2%). Klebsiella pneumoniae and Haemophilus influenzae were grown in CSF in 1 patient with a shunt.  

Conclusion: CNS infections are a cause of morbidity and mortality and patients presenting to the emergency department with signs and symptoms of CNS infection require rapid and careful evaluation. Non-CNS pathologies and non-infectious CNS pathologies should also be considered in these cases.