Evaluation of Patients Admitted to the Emergency Medicine Department with Symptoms of Central Nervous System Infection

Aim: We aimed to investigate the demographic data, diagnoses
and predictive factors for infection in patients admitted to the
emergency department with central nervous system (CNS)
symptoms and signs.
Material and Method: We retrospectively analyzed 88 cases
admitted to the emergency department of a tertiary care
university training and research hospital with central nervous
system symptoms in terms of demographic data, examination
findings, hospitalization status, cerebrospinal fluid (CSF)
culture growth and mortality. The cases were analyzed in 3
groups as central nervous system infection, non-infectious
central nervous system pathologies and pathologies other
than central nervous system.
Results: Out of 88 patients, 17 (19.3%) had central nervous
system infection. Purulent meningitis was diagnosed in 11
(64.7%) and encephalitis in 6 (35.2%) of these cases. Complaints
of vomiting, CSF culture collection rate, Kernig sign positivity,
nuchal rigidity and hospitalization rate were significantly
higher in the CNS infection group compared to the other two
groups. There was no difference between the groups in terms
of mortality. In cases of purulent meningitis, CSF cultures were
collected from 9 of 11 patients and growth was observed in
2 samples (22.2%). Klebsiella pneumoniae and Haemophilus
influenzae were grown in CSF in 1 patient with a shunt.
Conclusion: CNS infections are a cause of morbidity and
mortality and patients presenting to the emergency
department with signs and symptoms of CNS infection require
rapid and careful evaluation. Non-CNS pathologies and noninfectious
CNS pathologies should also be considered in these
cases.