Clinical Presentation and Outcomes of Bacterial Meningitis

Clinical Presentation and Outcomes

Clinical Presentation and Outcomes of Bacterial Meningitis in University Hospital

Subject Area: Education / Adult Learning / Biostatistics

Modified: 19th August 2025

Meningitis is a leading cause of mortality and long-term disability globally. There are also geographical variations in the occurrence of meningitis, and this may be more pronounced in developing countries. In adults, the primary bacterial organisms responsible for meningitis are Haemophilus influenzae and Streptococcus pneumoniae. Although there have been a number of studies of childhood meningitis in Saudi Arabia, fewer studies have concentrated on adults. One study conducted by Abdulrab et al. found Streptococcus pneumoniae to account for the majority of cases, with a mortality rate of 22.3%. Common symptoms of meningitis include fever, headache, and neck stiffness, with a diagnosis verified with analysis of the cerebrospinal fluid (CSF). This study will determine the clinical features and outcomes of bacterial meningitis in adults in Saudi Arabia.

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Biostatistics Results

This study involved 60 patients admitted with meningitis symptoms. The age distribution revealed that the highest frequency of symptoms occurred in those aged 45 and older (30%) (Figure 1).

Table Of Content

Referencing Tools

S. No

1 Symptoms of patients with meningitis

2 Laboratory characteristics of meningitis patients

3 Treatments administered to meningitis patients

6

4 Complications associated with meningitis

7

5 Binary logistic regression predicting meningitis diagnosis via CT scan findings

7

6 Binary logistic regression for predicting meningitis via CSF culture findings

7 Binary logistic regression for predicting meningitis via MRI findings

7 Symptoms of patients with meningitis

Symptoms	Number patients	Percent (%)
Fever	48	(80.0)
Headache	29	(48.3)
Vomiting	12	(20.0)
Altered mental status	42	(70.0)
Neck rigidity	25	(41.7)
Photo phobia	6	(10.0)
Dizzyness	3	(5.0)
Fits	19	(31.7)

The symptoms encountered in patients included fever, headache, vomiting, altered mental status, neck stiffness, photophobia, and dizziness. The majority of patients (80%) experienced fever, followed by altered mental status (70%) (Table 1).

Among the 60 patients suspected of having meningitis, most were female (71.7%) and non-Saudis (73.3%). The most common symptoms at admission were fever (80%), altered mental status (70%), headache (48.3%), neck stiffness (41.7%), seizures (31.7%), vomiting (20%), photophobia (10%), and dizziness (5%) (Figure 2).

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Laboratory characteristics of meningitis patients

Laboratory	Mean(SD)
CSF-WBC	3.41(2.16)
CSF -RBC	3.95 (2.49)
CSF-GLU	3.91(2.60)
CSF-PROT	1.30(1.03)

Laboratory results showed a mean CSF WBC count of 3.41 ± 2.16, CSF RBC count of 3.95 ± 2.49, CSF glucose levels of 3.91 ± 2.60, and CSF protein levels of 1.30 ± 1.03.

Treatments administered to meningitis patients

Treatments	Number of patients (%)
TB on Admission	8(13.3)
Ceftrixone on admission	53(88.3)
Vancomicin on admission	52(86.7)
Acyxlovir on admission	35(58.3)
Change of antibiotics after 24 hours	13(21.7)

Regarding treatment, 53 (88.3%) patients were given ceftriaxone, 52 (86.7%) received vancomycin, 35 (58.3%) were treated with acyclovir, and 13 (21.7%) patients had their antibiotics switched within 24 hours. Eight patients (13.3%) were diagnosed with tuberculosis during admission (Table 3).

Complications associated with meningitis

Complication	Number of patients (%)
Stroke	5(8.3)
Cranial nerve palsy	2(3.3)
Hydrocephalous	2(3.3)

The study also identified complications in meningitis patients, including 5 (8.3%) cases of stroke, 2 (3.3%) cases of cranial nerve palsy, and 2 (3.3%) cases of hydrocephalus (Table 4).

Binary logistic regression predicting meningitis diagnosis via CT scan findings

Risk factors	Odds Ratio( C.I Lower- Upper)	P-Value
Fever	1.200(0.316-4.560)	0.789
Altered level of consciousness	2.625(0.739-9.330)	0.136
fits	0.504(0.153-1.666)	0.261
Neck rigidity	0.519(0.173-1.558)	0.242
Headache	0.463(0.157-1.360)	0.161
Photophobia	0.314(0.034-2.881)	0.306
Vomiting	0.509(0.122-2.124)	0.354
Dizzyness	3.700(0.316-43.365)	0.297

Dependent variable: Brain CT scan

Table 5 presents the unadjusted odds ratios for risk factors associated with meningitis, as identified by CT scan findings. No significant association was found (p > 0.05) with CT scan results and/or symptoms.

Binary logistic regression for predicting meningitis via CSF culture findings

Risk factors	Odds Ratio( C.I Lower- Upper)	P-Value
Fever	0.478(0.040-5.762)	0.561
fits	1.083(0.092-12.738)	0.949
Neck rigidity	0.688(0.059-8.026)	0.765
Headache	0.518(0.044-6.037)	0.599

Dependent variable: CSF-Culture findings
Similarly, Table 6 shows the unadjusted odds ratios for selected risk factors associated with CSF culture results. Again, no significant association (p > 0.05) was observed between CSF culture findings and symptoms.

Binary logistic regression for predicting meningitis via MRI findings

Risk factors	Odds Ratio( C.I Lower- Upper)	P-Value
Fever	0.462(0.114-1.876)	0.280
Altered level of consciousness	0.955(0.252-3.622)	0.945
fits	1.473(0.409-5.300)	0.553
Neck rigidity	0.844(0.240-2.969)	0.791
Headache	1.326(0.387-4.544)	0.654
Vomiting	0.273(0.032-2.339)	0.236
Dizzyness	8.364(0.694-100.771)	0.094

Dependent variable: MRI findings meningitis disease
Table 7 displays unadjusted odds ratios for the risk factors associated with MRI results in meningitis patients.

Conclusion

This study emphasizes the complications and predictors of bacterial meningitis in Saudi Arabia. It focuses on the clinical features and outcomes in adult patients. Given the seriousness of the disease, it is recommended that supportive care is offered, and that meningitis is prevented where possible, especially through vaccination and awareness campaigns to reduce the instances of cases.