Management, complications, and outcome of l00 cases of meningococcal meningitis in gezira state, central sudan in l999

Abstract EN

Objectives: To determine the serogroup of the meningococcus responsible for the epidemic that occurred in Wad Medani Central Sudan in l999; to show the effectiveness of a combination therapy of a single dose of chloramphenicol with crystalline penicillin in the management; and to determine complications which occurred at that particular time.

Methods: l00 patients suspected of having meningococcal meningitis were included in the study.

Thorough history and physical examinations including CSF examination were done on all patients.

The CSF was examined with Gram stain, culture, and serogrouping.

All patients received a single dose of 3 g of chloramphenicol and crystalline penicillin 3 mega units 6 hourly IVfor 5 days.

Results: The age ranged between l5 to 65 years, and there were 64 males and 36 females.

The CSF was turbid in 80% of the cases and under high pressure in 95%.

Fifteen cases showed Neisseria meningitidis Group A when cultured.

By the 5th day of treatment, most of the patients had recovered completely.

Complications included: death (2 patients), arthritis, deafness, and deterioration in vision.

Conclusion: Neisseria meningitidis Group A was responsible for the epidemic.

Chloramphenicol with crystalline penicillin was an effective treatment.

Monoarticular arthritis was the most common complication with the knee joint being the most frequently affected.