Title: A Clinical Outcome of Dexamethasone therapy of Patients with Pyogenic Meningitis
Authors: Atul Kumar, Md Izhar Alam, Taskeen Ahmad Reza, Shruti Sonal, Kaushal Kumar Sinha, Karan Bhargav, Wasim Alam
DOI: http://dx.doi.org/10.18535/jmscr/v4i7.33
Objective: Observation of hastening effect of dexamethasone on recovery time and reductions of case fatality and neurological complications of pyogenic meningitis. Methodology: A total of 39 patients with pyogenic meningitis were considered on the basis of short clinical history and laboratory findings like, fever, headache, projectile vomiting, confusion/delirium, unconsciousness and neck rigidity and kerning’s sign, raised CSF pressure, presence of turbidity or purulent CSF with identification of bacteria on gram staining or culture of CSF, High CSF cell count (> 10 to < 10000 /Cumm) with neutrophilic predominance, Reduced CSF glucose level (<40mg%), Low CSF to blood glucose concentration ratio (<40 %), High CSF protein level (>50mg/dl). Results: Data was analyzed by using MS-Office software. Conclusions: Adjunctive dexamethasone therapy may improve the outcome of pyogenic meningitis in adolescent and adult patients. And the intensity of headache, vomiting and fever were also relieved by using dexamethasone therapy. Key words: pyogenic meningitis, dexamethasone therapy, clinical outcome 1. Karen L. Roos, Kenneth L. Tyler: Meningitis, Encephalitis brain abcess and empyema: Harrisons principles of internal medicine. Vol II, 16th edition, McGraw Hill company, 2005;360:2471-2477. 2. Enting R: Dexamethasone for bacterial meningitis; we need the answer; Lancet 1997 April 19;349 : 1179-80. 3. McIntyre P. Dexamethasone treatment for acute bacterial meningitis; how strong is the evidence for routine use? J Neurol Neurosurg Psychiatry; 1996 April: 60(4): 464-5. 4. Venkatachalam R: Streroid/Dexamethasone in adults with bacterial meningitis. J. Assoc. Physician India 1996 September; 44(a):668. 5. Townsend GD, Scheld WM: The use of corticosteroid in management of bacterial meningitis in adult. J Antimicrobe Chemother. 1996; 37:1051-1061. 6. Tunkel AR, Scheld WM: Pathogenesis and pathophysiology of bacterial meningitis. Annu Rev Med 1993; 44 : 103-104. 7. Awasthi S, Moin S, Lyer SM, Renham H: Modified Glasgow Coma Scale to predict mortality in children with acute infection of the CNS. National Medical Journal of India , 1997 September ; 10(5): 214-16. 8. Lebell MH et al. dexamethasone therapy for bacterial meningitis: Results of two double blind, placebo controlled trials. N. Engld. J. Med. 319; 964: 1988. 9. Kanra GY, Ozen H, Secmeer G et al. Beneficial effect of dexamethasone in children with pneumococcal meningitis. Pediatric infection disease J. 1995; 14: 490-494. 10. Odio CM et al. The beneficial effects of early dexamethasone administration in infant and children with bacterial meningitis. N. Engld. J Med. 1991; 324: 1525. 11. Pilchard E Gillis D, Aker M, et al. Rebound fever in bacterial meningitis; Role of dexamethasone dosage. Isr. J Med. Sci. 1994 May-June; 30(5-6): 408-16. 12. Van Wees J, Tegtmeyer KF: Value of dexamethasone therapy in bacterial meningitis. Monatsschr Kinderhailkd 1993 Sept; 141(9): 732.Abstract
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