Meningoencefalite: dados clínicos, bacteriológicos e terapêuticos em 351 casos

Abstract

351 cases of menmgoencephalitis are presented. The aim of thís paper is to show the most frcquent etiologies and the therapeutic results obtained with an association of Penicilin G, Sulfadiazine and Chloramphenmoi and with a hroad-spectrum *emi-*ynthelie penicillin. A syndromic classificatioa of the neurological pícture ia relation to the duratíon of the disease before hospitalization and the clinicai evolution is presented. The meningoencephalites contributed with 21,26% of the hospiatl casuistic: acute bacterial meningoencephalitis o c c ur r 'e d in 48,14% of the total; asseptic (virai and undetermined) in 46,72% and tuberculous in 5,09%. In the acute bacterial group, meningococcus was responsible for 56,1% of the cases, staphylococcus for 14,47%, pneumococcus for 11,34%, Pfeiffer's bacillus for 5,46%. Proteus, Pseudomonas, Klebsiella and streptococci occurred in less than 8% of the bacterial group. A puré meningeal syndrome was observed more f requently in patíents with less than two days of disease who presented a more favourable evolution than the patíents with signs of encephalic and medullary involvelment. Hospital mortality in the patients treated with a combination of penicillin G — sulfa — chloramphenicol, in 79 cases, was 25,32%; with epicillin in 36 cases was 16,66% and with ampicillin in 54 cases, 14,82%. It is concluded that meningococcus is the most important etiologíc agent of meningoencephalitis in Goiás, that a single ínitial therapy with broad-spectrum penicillin is superior thant the association of penicillin G — sulfadíazie — chloramphenicol and that a syndromic classification of the neurological picture ís useful for the evaluation of prognosis.