PATTERN OF CENTRAL NERVOUS SYSTEM INFECTIONS IN THE UNIVERSITY COLLEGE HOSPITAL IBADAN (1981-2006)

Abstract

Design
This retrospective study was carried out at the Department of Pathology, University
College Hospital, Ibadan, Nigeria.
Aim
The aim of the study was to determine the pattern of CNS infections seen in the
Department of Pathology, UCH, Ibadan.
Methods
Autopsy records of CNS infections diagnosed at the Department of Pathology, University
College Hospital, Ibadan between January 1981 and December 2006 were reviewed.
Information on age, sex, clinical presentation, anatomical location and gross and
microscopic findings were retrieved and the glass slides were reviewed, where available.
Results
There were 408 CNS infections, with a progressive decline in the frequency of CNS
infection diagnosed at autopsy during the study period. The male to female ratio was
1.3:1 and the patients ranged from 2 to 81 years of age, with 186 (45.6%) cases occurring
in children aged 9 years and below. The most common CNS infections were pyogenic
meningitis (54.9%), tuberculous meningitis (21.6%) and cerebral malaria (12.7%). A
correct ante-mortem diagnosis of pyogenic meningitis, tuberculous meningitis, cerebral
malaria and brain abscess was made in 41.5%, 19.3%, 40.4% and 11.5% of the cases,
respectively.
Conclusion
CNS infections are often diagnosed late or are misdiagnosed, resulting in considerable
morbidity and mortality. There is a need for a high clinical index of suspicion on the part
of clinicians.

PATTERN OF CENTRAL NERVOUS SYSTEM INFECTIONS IN THE UNIVERSITY COLLEGE HOSPITAL IBADAN (1981-2006)