Aspectos dos líquidos cefalorraquidianos nas meningites bacterianas

Campos, Claudia E. O. Pires de; Santos, Nilse N. Q.; Takahashi, Mirian N.; Kawamura, Isabel E.; Damião, Silvia V.; Kushnaroff, Tuba M.; Campos, Evanil Pires de

doi:10.1590/S0037-86821994000200006

Resumos

Foram colhidos 1815 líquidos cefalorraquidianôs de doentes internados com meningite, no Hospital Emílio Ribas, São Paulo, durante os meses de maio a outubro de 1989. Neisseria meningitidis 56%, dos quais 44% do tipo B; Haemophilus influenzae 17%, sendo 72 % isoladas de neonatos até 3 anos; Streptococcus pneumoniae 14%, dos quais 60% isolados de recém nascidos a 1 ano de idade. O estudo citoquímico liquórico mostrou: celularidade: global > 500cel/mm³ e específica > 70%; proteínas > 90mg/dl e glicose < 45mg/dl em 90% e celularidade < 500cel/mm³ entre 2 a 6% nos três tipos de meningites avaliadas. A bacterioscopia e o citoquímico Uquóricos foram decisivos na orientação da cultura epreditivos no diagnóstico etiológico dessas meningites (Teste de Goodman).

Liquor; Meningites bacterianas

Samples of 1815 cerebrospinal fluid (CSF) were studied in a meningitis outbreak during 1989 in São Paulo, Brazil. Neisseria meningitis 56% with 44% type B, Haemophilus influenzae 17%, from which 72% in children (days to 3-year old) and Streptococcus pneumoniae 14% from which 60% in children (day to 1- year old) of443 (24 %)of allstrains. Cytochemistry study showed: purulent or turbidity aspects in 70 to 79% positive bacterioscopy or culture of CSF; white cells count > 500/mm³; glucose < 45mg/dl; protein > 90mg/dl in 90% of all patients. We concluded that: CSF prognostic factors: (aspect and cytochemistry) were correlated with bacterial meningitis. Bacterioscopy and positive cultures were correlated to NM, SP and HI isolation from these patients (Goodman Test.)

Cerebrospinal fluid; Bacterial meningitis

ARTIGOS

Aspectos dos líquidos cefalorraquidianos nas meningites bacterianas

Claudia E. O. Pires de Campos; Nilse N. Q. Santos; Mirian N. Takahashi; Isabel E. Kawamura; Silvia V. Damião; Tuba M. Kushnaroff; Evanil Pires de Campos

^{Endereço para correspondência} Endereço para correspondência: Dra. Claudia E. O. P. Campos. R. João Rafael 350, 18602-220 Botucatu, SP, Brasil.

RESUMO

Foram colhidos 1815 líquidos cefalorraquidianôs de doentes internados com meningite, no Hospital Emílio Ribas, São Paulo, durante os meses de maio a outubro de 1989. Neisseria meningitidis 56%, dos quais 44% do tipo B; Haemophilus influenzae 17%, sendo 72 % isoladas de neonatos até 3 anos; Streptococcus pneumoniae 14%, dos quais 60% isolados de recém nascidos a 1 ano de idade. O estudo citoquímico liquórico mostrou: celularidade: global > 500cel/mm³ e específica > 70%; proteínas > 90mg/dl e glicose < 45mg/dl em 90% e celularidade < 500cel/mm³ entre 2 a 6% nos três tipos de meningites avaliadas. A bacterioscopia e o citoquímico Uquóricos foram decisivos na orientação da cultura epreditivos no diagnóstico etiológico dessas meningites (Teste de Goodman).

Palavras-chave: Liquor. Meningites bacterianas.

ABSTRACT

Samples of 1815 cerebrospinal fluid (CSF) were studied in a meningitis outbreak during 1989 in São Paulo, Brazil. Neisseria meningitis 56% with 44% type B, Haemophilus influenzae 17%, from which 72% in children (days to 3-year old) and Streptococcus pneumoniae 14% from which 60% in children (day to 1- year old) of443 (24 %)of allstrains. Cytochemistry study showed: purulent or turbidity aspects in 70 to 79% positive bacterioscopy or culture of CSF; white cells count > 500/mm³; glucose < 45mg/dl; protein > 90mg/dl in 90% of all patients. We concluded that: CSF prognostic factors: (aspect and cytochemistry) were correlated with bacterial meningitis. Bacterioscopy and positive cultures were correlated to NM, SP and HI isolation from these patients (Goodman Test.)

Keywords: Cerebrospinal fluid. Bacterial meningitis.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Recebido para publicação em 18/01/94.

Hospital Emílio Ribas, São Paulo, SP e Instituto de Biociências e Universidade Estadual Paulista, Botucatu, SP.

1. Bryan J, Silva H, Tavares A, Rocha H, Sheld W. Etiology and mortality of bacterial meningitis in northeastern Brazil. Review of Infectious Diseases 12:128-135, 1990.
2. Cowan ST, Steeel KJ. Manual of thg identification of medical bacteria. 2^nd edition, Cambridge University p. 238, 1974.
3. Edward DL, Ewing NH. Identification of Enterobacteriacceae. 3^th edition, Burgess, Minneapolis p. 362, 1972.
4. Feigin RD. Bacterial meningitis beyond the neonatal period, ln: Feigin RD, Cherry JD (eds) Textbook of Pediatric Infectious Diseases. Saunders, Philadelphia p. 916, 1992.
5. Girgis NI, SppelJE, Kilpatrick ME, Sanborn WR, Mikai IA, Cross E, Erian MW, Sultan Y, Farid Z. Meningitis and encephalitis at the Abbassia Fever Hospital, Cairo, Egypt, From 1966 to 1989. The American Journal of Tropical Medicine and Hygiene 48:97-107, 1993.
6. Glimaker M, Kragsberg P, Forsgeen M, Olcen P. Tumor necrosis factor (T.N.F∝) in cerebrospinal fluid from patients with meningitis of different etiologies: high levels of TNF∝ indicate bacterial meningitis. The lournal of Infectious Diseases 167:882-889, 1993.
7. Goodman LA. Simultaneous confidence intervals for contrast among multinomial populations. Annals of Matematical-Statistic 35:716-775, 1964.
8. Greenwood BM, Greenwood AM, Bradley AK. Factors influencing susceptibility in meningococcal disease during an epidemie in the Gambia - West Africa. Journal of Infectious 14:167-184, 1987.
9. Kilpatrick M, Mikail I, Girgis N. Negative culture of cerebrospinal fluid in partially treated bacterial meningitis. Tropical Geographic Medicine 39:345- 349, 1987.
10. Kumar P, VermalC. Antibiotic therapy for bacterial meningitis in children in developing countries. Bulletin of the World Health Organization 71:183- 188, 1993.
11. LennetteEH, Ballows A, Hausler WJ, Shadomy HJ. Manual of clinical Microbiology. American Microbiology Society, 4^th edition, Washington DC, 1985.
12. Lindquist L, Linne T, Hansson LO, Kalin M, Axelsson G. Value of cerebrospinal fluid analysis in the differential diagnosis of meningitis a study in 710 patients with suspected central nervous system infection. European Journal o f Clinical Microbiology Infectious Diseases 7:374-380, 1988.
13. Pinner RW, Onyango F, Perkins BA, Mirza NB, Ngacha DM, Reever M, DeWitt W, Njeru E, Agata NN, Broome CV and Kenya Centers for Disease Control (C.D .C.) Meningitis Study Group. Epidemic meningococcal disease in Nairobi, Kenya, 1989. The Journal of Infectious Diseases 166:359-364, 1992.
14. Stocco JM, Porfirio FM V, Carvalho VO, Nunes FF, Santos NNQ, Campos CEOP, Schmal MR, Kuschnaroff TM. Septicemia com purpura por Haemophilus influenzae e sua semelhança com meningococcemia. In: XXVI Congresso da Sociedade Brasileira de Medicina Tropical, Natal p. 196, 1990.
15. Tzanakaki G, Blackwell CC, Kremastion J, Weir DM, Montes A, Fallon BJ. Serogroups; serotypes and subtypes of Neisseria meningitis isolated from patients and carrier in Greese. Journal of Medical Microbiology 38:19-22, 1993.
16. Wright PW, Avery WG, Ardill WD, McCarty JW. Initial clinical assessment of the comatose patient: cerebral malaria vs meningitis. Pediatric Infectious Diseases Journal 12:37-41, 1993.

Endereço para correspondência:

Dra. Claudia E. O. P. Campos.

R. João Rafael 350,

18602-220

Botucatu, SP, Brasil.

Datas de Publicação

Publicação nesta coleção
10 Abr 2013
Data do Fascículo
Jun 1994

Histórico

Aceito
18 Jan 1994
Recebido
18 Jan 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Bryan J, Silva H, Tavares A, Rocha H, Sheld W. Etiology and mortality of bacterial meningitis in northeastern Brazil. Review of Infectious Diseases 12:128-135, 1990.

[2] 2. Cowan ST, Steeel KJ. Manual of thg identification of medical bacteria. 2^nd edition, Cambridge University p. 238, 1974.

[3] 3. Edward DL, Ewing NH. Identification of Enterobacteriacceae. 3^th edition, Burgess, Minneapolis p. 362, 1972.

[4] 4. Feigin RD. Bacterial meningitis beyond the neonatal period, ln: Feigin RD, Cherry JD (eds) Textbook of Pediatric Infectious Diseases. Saunders, Philadelphia p. 916, 1992.

[5] 5. Girgis NI, SppelJE, Kilpatrick ME, Sanborn WR, Mikai IA, Cross E, Erian MW, Sultan Y, Farid Z. Meningitis and encephalitis at the Abbassia Fever Hospital, Cairo, Egypt, From 1966 to 1989. The American Journal of Tropical Medicine and Hygiene 48:97-107, 1993.

[6] 6. Glimaker M, Kragsberg P, Forsgeen M, Olcen P. Tumor necrosis factor (T.N.F∝) in cerebrospinal fluid from patients with meningitis of different etiologies: high levels of TNF∝ indicate bacterial meningitis. The lournal of Infectious Diseases 167:882-889, 1993.

[7] 7. Goodman LA. Simultaneous confidence intervals for contrast among multinomial populations. Annals of Matematical-Statistic 35:716-775, 1964.

[8] 8. Greenwood BM, Greenwood AM, Bradley AK. Factors influencing susceptibility in meningococcal disease during an epidemie in the Gambia - West Africa. Journal of Infectious 14:167-184, 1987.

[9] 9. Kilpatrick M, Mikail I, Girgis N. Negative culture of cerebrospinal fluid in partially treated bacterial meningitis. Tropical Geographic Medicine 39:345- 349, 1987.

[10] 10. Kumar P, VermalC. Antibiotic therapy for bacterial meningitis in children in developing countries. Bulletin of the World Health Organization 71:183- 188, 1993.

[11] 11. LennetteEH, Ballows A, Hausler WJ, Shadomy HJ. Manual of clinical Microbiology. American Microbiology Society, 4^th edition, Washington DC, 1985.

[12] 12. Lindquist L, Linne T, Hansson LO, Kalin M, Axelsson G. Value of cerebrospinal fluid analysis in the differential diagnosis of meningitis a study in 710 patients with suspected central nervous system infection. European Journal o f Clinical Microbiology Infectious Diseases 7:374-380, 1988.

[13] 13. Pinner RW, Onyango F, Perkins BA, Mirza NB, Ngacha DM, Reever M, DeWitt W, Njeru E, Agata NN, Broome CV and Kenya Centers for Disease Control (C.D .C.) Meningitis Study Group. Epidemic meningococcal disease in Nairobi, Kenya, 1989. The Journal of Infectious Diseases 166:359-364, 1992.

[14] 14. Stocco JM, Porfirio FM V, Carvalho VO, Nunes FF, Santos NNQ, Campos CEOP, Schmal MR, Kuschnaroff TM. Septicemia com purpura por Haemophilus influenzae e sua semelhança com meningococcemia. In: XXVI Congresso da Sociedade Brasileira de Medicina Tropical, Natal p. 196, 1990.

[15] 15. Tzanakaki G, Blackwell CC, Kremastion J, Weir DM, Montes A, Fallon BJ. Serogroups; serotypes and subtypes of Neisseria meningitis isolated from patients and carrier in Greese. Journal of Medical Microbiology 38:19-22, 1993.

[16] 16. Wright PW, Avery WG, Ardill WD, McCarty JW. Initial clinical assessment of the comatose patient: cerebral malaria vs meningitis. Pediatric Infectious Diseases Journal 12:37-41, 1993.