Vol. 7, Issue 2, Part E (2025)

Background: Meningoencephalitis is a global health problem as mortality is high and a large proportion of survivors suffered from significant morbidity. Physicians are facing the challenge of emergency identification of this clinical syndrome, establishing its etiology and prompt treatment to ensure survival and prevent long-term sequelae in these patients. The aim of this study was to evaluate the etiology and short-term outcome of meningoencephalitis patients admitted in a tertiary care hospital of Bangladesh. 
Objectives: The main objective was to evaluate the Microbiological etiology and short-term outcome of meningoencephalitis patients admitted in to medical wards of a tertiary care hospital.
Methods: A hospital-based descriptive study was conducted in the Department of Medicine, Sir Salimullah Medical College Mitford Hospital, from July 2022 to June 2023. 50 Patients enrolled within the study period with features of Meningoencephalitis fulfilling the inclusion and exclusion criteria. Ethical clearance for the study was obtained from the Ethical Review Committee. A detailed history, clinical examination was carried out. In addition to the routine blood test, CSF samples were collected as soon as possible from all patients unless contraindicated and sent for cytological, biochemical, and microbiological tests. Tests were carried out as early as possible after sample collection. Data were collected in the pre-formed standard data collection form. Data were recorded in separate case records and analyzed by SPSS 26.0.
Results: In this study most of the study participants 30 (60%) were female. The male female ratio was 1:1.5. Our results demonstrate the most of the cases (24, 48%) was tubercular meningoencephalitis, followed by (15, 30%) bacterial meningoencephalitis and (11,22%) viral meningoencephalitis. All the patients presented with fever and altered mental status. Gram positive diplococci found in 5 (33%) participants, 1 (6%) participant detected to had S. pneumoniae in PCR in the bacterial meningoencephalitis group. 1 (9%) participant detected to had Herpes simplex and 1 (9%) Varicella zoster in PCR among viral meningoencephalitis group. MTB detected in 8 (33%) participants in the tubercular meningoencephalitis group. Most of the participants 7 (46%), who was diagnosed with bacterial meningoencephalitis were severely disabled, 7 (63%) who was diagnosed with viral meningoencephalitis had good recovery, and 18 (75%) who was diagnosed with tubercular meningoencephalitis were severely disabled, 3 (12%) died. Mean ± SD of the duration of hospital stay of the tubercular meningoencephalitis was highest (31.91 ± 12.46 days). Most of the participants who had a poor outcome presented with headaches, GCS<8 with an odds ratio of 9.84 were statistically significant (p<0.05), increased ESR (mm in 1 st hour), decreased Glucose (mg/dl) in CSF, abnormal CT/MRI Findings, low GOS E score, increased duration of hospital stay between the participants who had a poor outcome, were statistically significant (p<0.05). Among the factors, glucose in CSF is the strongest predictor of outcome with an odds ratio of 2.134.
Conclusion: In this study tubercular meningoencephalitis was the most common microbiological etiology of meningoencephalitis and most of the patients 18 (75%) were severely disabled, 3 (12.5%) died.