Clinical and Neurological comparisons of Acute meningitis in adults In Coastal Kenya

Abstract

Acute meningitis in adult patients remains a leading cause of high mortality and disability among infectious diseases of the nervous system. The aim of this study was to perform a comparative analysis of the clinical and neurological manifestations of acute meningitis of various etiologies to identify specific factors influencing disease outcomes. A representative group of adult patients with a confirmed diagnosis of acute meningeal involvement was included in the study. The methodology employed a complete neurological examination, a dynamic assessment of consciousness using the Glasgow Coma Scale, a lumbar puncture with microbiological, cytological, and biochemical analysis of cerebrospinal fluid, and molecular genetic testing of cerebrospinal fluid. The study revealed significant differences between bacterial and viral forms: bacterial meningitis is characterized by an acute onset, a high incidence of altered consciousness progressing to obtundation or coma, severe meningeal syndrome, and high levels of pleocytosis with a predominance of neutrophils. Viral infections were characterized by a more moderate course, with predominantly lymphocytic pleocytosis and preserved consciousness in most patients. The conclusion underscores that early identification of specific neurological markers, combined with urgent cerebrospinal fluid analysis, is essential for the timely adoption of a differentiated therapeutic strategy and for reducing the risk of adverse neurological outcomes.