STUDY TO DETERMINE THE INCIDENCE OF HYPONATREMIA IN COMMUNITY ACQUIRED TUBERCULAR AND BACTERIAL MENINGITIS

Introduction: Bacterial and tuberculous meningitis is a life-threatening disease. Hyponatremia in bacterial and tuberculous meningitis is a known complication with unknown actual incidence and clinical significance. This study was conducted to determine how common hyponatremia occurs in community-acquired bacterial and tuberculous meningitis to assess its severity, see a pattern of symptoms, and monitor levels of consciousness.

Material and methods: It was a descriptive cross-sectional study conducted on 30 admitted patients with clinically diagnosed bacterial and tuberculous meningitis at the Medicine Units of Allied Hospital, Faisalabad for one-year duration from August 2019 to August 2020. The level of electrolytes in the serum and the level of consciousness on admission were recorded in all patients.

Results: Twenty-nine patients (96.7%) with meningitis developed hyponatremia, serum sodium concentration ranged from 115–138 mmol / l; mean sodium level is 128.57 ± 5.56 SD mmol / l. Serum sodium concentration was mild (> 125-135 mmol / l) in 20 (66.7%) patients with meningitis and moderate (110-125 mmol / L) in 9 (30%) and severe (<110 mmol / L) in 1 (3.3%) patient. GCS ranged from 8 to 14, mean 11.56 ± 1.40 SD on day 1. In tuberculous meningitis (n = 8) and bacterial meningitis (n = 22), the serum sodium concentration was 128.63 ± 7.44 and 128.55 ± 4.93, while the mean GCS was 11, 38 ± 2.13 and 11.95 ± 1.40 on the day of admission, respectively.

Conclusion: Although the true incidence, severity, and clinical significance of hyponatremia in bacterial meningitis are unknown, its presence may influence outcomes in these patients depending on severity. So, knowing its prevalence and severity will guide doctors in making decisions about its treatment.

Key words: hyponatremia, meningitis, adults