Computed tomography study of complicated bacterial meningitis

Objective: To monitor the structural intracranial complications of bacterial meningitis using computed tomography (CT) scan. Design: Retrospective study of medical and radiological records of patients who underwent CT scan over a 4 year period. Setting: A University Teaching Hospital in a developing country. Subjects: Thirtythree patients with clinically and laboratory-proven cases of bacterial meningitis who had clinical features of central nervous system complication of the disease. Outcome measures: Only patients with available complete records were studied with material obtained from the medical records and radiology departments of the hospital. Results: Persistent headache (30.3%), persistent fever (18.18%), seizures (15.5%) and torticollis (12.12%) were the most common presenting features that necessitated the request for CT scan. Communicating hydrocephalus (36.36%), cerebral abscess (12.12%), multiple areas of cerebral infarction (12.12%) and subdural empyema (9.09%) were the most common CT scan findings. The complications were more common in children aged less than 15 years. Conclusions: Computed Tomography is an accurate and useful means of diagnosing intracranial complications of bacterial meningitis. Early and effective diagnosis of treatable lesions such as hydrocephalus, cerebral abscess and subdural empyema will help improve prognosis of the patients. There appears to be no alternative to prevention, adequate and early treatment of this condition to reduce its long-term neurological sequelae.