Management of patients with suspected meningitis or meningoencephalitis. Are we compliant with guidelines

Background: Central Nervous system infections are associated with high morbidity and mortality. Initial presentation can be very non-specific, the classic triad of: fever, headache and altered mental status only found in 44% of patients with acute bacterial meningitis. In a recent study a delay in antimicrobial treatment of more than three hours after hospital admission was a strong and independent risk factor for mortality. Methods: We reviewed case notes of patients presented with suspected meningitis or meningoencephalitis. We designed a Performa to collect information on presentation, clinical findings, investigation and management of these patients. Results: 30 case notes were reviewed. 16 out of 30 patients had at-least 2 out of 3 classic features. Skin rash was not looked for in 53% patients. 83% patients had no documentation regarding presence or absence of papilledema. 75% of patients appropriately had CT Brain done before LP. 56% of patients had appropriate antibiotics in less than 3 hours. Mean...