Aetiology of acute bacterial meningitis in the highlands & islands of Papua New Guinea.

The aetiology of acute bacterial meningitis in adults was investigated in Papua New Guinea. During a five-year period, a total of 228 Melanesian adults with acute purulent meningitis were admitted to three major hospitals representing mainland coasts, highlands and islands of the country. Two-thirds of these patients had negative cerebrospinal fluid (CSF) cultures, presumably because they had received antibiotics prior to hospitalisation. Eighty of 84 bacterillogically confirmed cases were caused by either pneumococci or meningococci (95%). Pneumococcus was the most common organism encountered (59%). Three patients in the highland area and none in other areas had Heamophilus influenzae meningitis. These data provide the basis for formulating guidelines for the use of antibiotics in the treatment of acute bacterial meningitis in areas of Papua New Guinea where there are no facilities to examine or culture the CSF and in hospitals before the CSF culture result is known.