Clinical Features of Suspected CNS Infection in A Tertiary Care Center
Journal of Medical Science And clinical Research
Infections of the central nervous system are neurological emergencies requiring early recognition and efficient decision making. Clinical presentations are varied and non infective causes can also present with similar features. Aim and Objectives: To study the causes of altered sensorium and to analyze the profile of patients presenting with CNS infection. Methods: The study included 121 patients (73 males and 48 females) who met inclusion criteria (Age more than or equal to 18 years and
... 18 years and suspicion of CNS infection) admitted in Sri Ramachandra Medical College Hospital from the year 2009 to 2011. Clinical presentations were analyzed by questionnaire and detailed examination including a fundoscopy done. Results: Out of 121 patients, 90 had CNS infection. 15 patients had bacterial meningitis, 32 had tuberculous meningitis, 9 had aseptic meningitis, 30 had encephalitis and 4 had Cryptococcal meningitis. Viral encephalitis was seen more in younger age group. The most common presenting symptom was fever (105 patients), followed by altered sensorium (89), headache in (68), vomiting in (58) and seizures in 48 patients. Altered sensorium was universal in cryptococcal meningitis. 45.5% of patients with CNS infection presented with seizures while 35.5% had seizures in patients without infection. Mean duration of fever was 23 days for cryptococcal meningitis with TB meningitis having 15 days. 75% patients had neck stiffness and focal neurological deficits were seen in 9% patients. Fundus was abnormal in 28.1 % patients. Conclusion: Clinical presentation of CNS infections is a changing scenario. Young patients had more incidence. Fever and altered sensorium were the most common symptom. Neck stiffness was not an universal feature.