Bacterial Meningitis in Elderly Patients: Clinical Picture and Course

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Abstract
We reviewed the case records of 48 patients aged 60 years and older with a diagnosis of acute bacterial meningitis made during the period 1976–88. Predisposing conditions were present in 26 patients (54%) and concurrent infections in 24 patients (50%). Streptococcus pneumoniae accounted for 41% of all isolates and 56% were Gram-positive organisms. The most common symptoms were fever (79%), meningism (54%) and change in mental status (69%). Sixty-three per cent of the patients survived. Increased fatality was associated with absence of typical symptoms and signs and was presumably due to a delay in diagnosis. Other clinical and biochemical variables and antimicrobial therapy before admission to hospital and the presence of underlying disease were not associated with outcome.

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