DELAYED RECURRENT POST-TRAUMATIC BACTERIAL MENINGITIS: STUDY WITH A HIGHLIGHT ON SOME FORENSIC ASPECTS

Document Type : Original Article

Authors

1 forensic medicine and clinical toxicology department, faculty of medicine, Menoufia University. Egypt

2 Consultant of tropical medicine Shebin Elkom fever hospital

3 forensic and toxicology department, faculty of medicine, menoufia university

4 professor of Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Menoufia University

5 assistant professor forensic medicine and clinical toxicology department, faculty of medicine, Menoufia University. Egypt

Abstract

Introduction: Recurrent post-traumatic bacterial meningitis is a formidable delayed complication of head injury, which is indeed related to very high morbidity and mortality. Its recurrent nature can inflict a huge impact on the patient's life. Forensic investigation of this condition serves both; legal and medical interests.
The current study aimed to study the demographic, clinical, laboratory characteristics and outcomes of patients with delayed recurrent post-traumatic bacterial meningitis, and to shed light on some forensic aspects related to this condition.
Methodology: This retrospective study was done on cases of delayed recurrent post-traumatic bacterial meningitis admitted to Shebin El-kom Fever Hospital in Menoufia Governorate from January 2008 to December 2022.
Result: This study was conducted on 23 patients with delayed recurrent post-traumatic bacterial meningitis. The most common causes of trauma were road traffic accidents, followed by falls then assaults. Most patients had severe head injury (HI) and were hospitalized for an average duration of 10.5 days. Nineteen patients had cerebrospinal fluid (CSF) leaks, with a delayed time of its appearance in nine cases, with an average time of 11.9 months after HI. Most patients experienced their first meningitis attack within 2-12 months after the injury and the fatality rate of this condition was 17.4%.
Conclusion: Post traumatic recurrent bacterial meningitis has a heavy impact on the patient’s life and their families. Meningitis developing as a late complication of HI can have significant forensic importance as accurate diagnosis and proving causality can impact criminal responsibility, insurance claims, and compensation. Long-term follow-up for the potential occurrence of delayed leaks and meningitis after head injuries is important.

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