Neurosurgical complications related to bacterial meningitis in tropical areas.

Our retrospective study concerned 35 cases of surgical complications relate d to bacterial meningitis in 16 adults and 19 children. The mean age was 28 years for adults (15-56 years), and 6 months for children (1-12 months). P ortal of entry for meningitis was found in 12 cases (35 %): 8 sinusitis and 4 otitis. Delay to appearance of complications was 4.5 days, and to diagno sis confirmation 9 days with CT scan (17 cases), and transfontanellar ultra sonography (19 cases). The complications were : hydrocephalus, 19 cases (54 %), brain empyemas, 7 cases (20 %), abscesses, la cases (28,5 %), ventricu litis, 2 cases (6 %). Twenty-two bacteria were isolated from the CSF: Strep tococcus pneumoniae (15 cases), Haemophilus influenzae (5 cases), Neisseria meningitidis (I case), and Escherichia coli (2 case). Fourteen patients un derwent neurosurgical treatment based on aspiration in case of suppuration and external drainage in case of hydrocephalus. The associated medical trea tment was antibiotics combining third-generation cephalosporins, fluoroquin olone, and metronidazol, with a mean duration of 12 days. Recovery rate was 89 %, letality II %, and after effect rate were 33 %. Our results confirm the low frequency of neurosurgical complications related to bacterial menin gitis, but it emphazises the role of an early CT-scan for diagnosis and pro nosis.