[Bacterial meningitis in the adult. Study of 85 cases observed in the infectious disease unit of the Fondation Jeanne Ebori (F.J.E.), Libreville, Gabon].

We conducted a retrospective review to specify the frequency, identify the aetiological factors of bacterial meningitis in adults (BMA) and to evaluate the therapeutic protocol used. This study was conducted on 85 (BMA) cases of hospitalised patients between January 1991 and December 1995 (5 years) on our service. The BMA represented 3% of all admissions for infectious diseases at the Foundation Jeanne Ebori in Libreville. It occurred in an endemosporadic fashion. All patients were Black Africans with an average age of 33 years (range: 16-60 years). Males predominated by a ratio of 2.4. Tha patients were seen late in the evolution of the disease, as shown by the folloxing clinical signs: neuropsychic problems (100%), 25 patients (29%) were in a profound coma, 5 (6%) had a hemiplegia, 2 (2%) an hypoacousie and 1 (1%) seizure. Aetiological factors were found in 17 cases (20%) to be in the ORL sphere (sinusitis: n = 8, ear infection: n = 4), pneumopathies (n = 4) and one case of breach dure-mere. The predominant germ was pneumocoque, isolated in 55 cases (65%), 15 cases had a LCR clear (18%). Bacteria gram negative (6%) were identified in the immunocompromised HIV. Third generation cephems had an efficiency higher than beta lactamines: 83% against 73%. The mortality was 18%; 3% of the remaining patients had neurological deafness. The seriousness of the results of this survey calls for the urgent implementation of a surveillance programme.