• D R Kafle, M Subedi, and M Thapa.
• Department of Internal Medicine, Nobel Medical College, Biratnagar, Nepal.
• Kathmandu Univ Med J (KUMJ). 2017 Jan 1; 15 (57): 40-44.

AbstractBackground There are several etiologies of meningitis and encephalitis which must be considered in any patient presenting with fever, headache, neck stiffness and vomiting. Bacterial meningitis and viral encephalitis are medical emergencies and need urgent attention and treatment. Any delay in diagnosis and treatment has been shown to increase morbidity and mortality. Some of the survivors also have neurological sequel with a need for long term physical and occupational rehabilitation. Objective To find out common causes of meningitis, encephalitis, predictors of outcome, early and late complications of meningitis and encephalitis at Tertiary Care Hospital in Eastern Nepal. Method It is a prospective study which was conducted at Nobel Medical College Teaching Hospital from April 2015 to March 2016. Result A total of 52 patients participated in the study. Bacterial meningitis was the most common type of neuroinfection (40.4%) followed by tubercular meningitis (27%), viral encephalitis (17.3%) and viral meningitis (15.4%). Pneumococcus was the most common identified cause of meningitis accounting for 28.9% of bacterial meningitis. Japanese encephalitis was the most common identifiable cause of encephalitis accounting for 33% of cases. Low Glasgow Coma Scale at admission was significantly associated with worse neurological outcome (P<0.001). Similarly, high white blood cell count in blood was associated with worse neurological outcome (P=0.001). Conclusion Meningitis and encephalitis are neurological emergency. Prompt diagnosis and treatment is needed to improve survival. Neurological sequel is common after those infections which require long term rehabilitation.

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