Objectives: Described here is the clinical presentation and etiology of community-acquired meningitis in adult patients in a Baltimore community hospital from 1997 to 2006.
Method: A retrospective chart review was performed. Data were collected regarding demographics, presenting symptoms, cerebrospinal fluid findings, and outcome.
Results: Of 80 patients identified, 17 were diagnosed with bacterial meningitis, 18 with viral meningitis, 39 with aseptic meningitis of unclear etiology, and 6 with other noninfectious causes. Streptococcus pneumoniae was the most common bacterial pathogen. Herpes simplex virus, enteroviruses and West Nile encephalitis virus were the most common viral pathogens. The classic triad of fever, neck stiffness and change of mental status was less common than previously reported, found in 5.0% of all the patients and 21.4% of the patients with bacterial meningitis.
Conclusion: Meningitis should be suspected with any suggestion of central nervous system complaint, even in the absence of the classic triad of symptoms and signs.