Central nervous system infections : Etiological characteristics and factors associated with death in the infectious and tropical diseases department of Dakar Principal Hospital, Senegal

Abstract

Introduction : Describe the etiological features of central nervous system infections and identify factors associated with death related to these infections at the Department of Infectious and Tropical Diseases of Principal Hospital of Dakar. Design : It was a descriptive and analytical retrospective study covering the period from January 1, 2016 to December 31, 2019, including all patients with central nervous system infections hospitalized in the infectious and tropical diseases department. A bivariate analysis was performed to assess the factors associated with death related to these infections with a statistical significance level fixed at α = 0.05. Results : We enrolled 55 patients with CNSIs during the study period. Their median age was 36 years (IQR = 51 years – 25 years) and a male to female ratio of 1.3. Pathogens in cause was unknown in 52.7% of cases. Tuberculosis was the predominant cause with 30.9% of cases. Twelve patients (22%) died and factors associated with death were: HIV infection (p = 0.002), conscious ness disorders (p = 0.027), Babinski's sign (p = 0.03), abnormal reflexes (p = 0.049), cranial nerve involvement (p = 0.04) and anemia (p = 0.008). Conclusion : Our study confirmed the difficulty to find the causes of central nervous system infections, and underline their high lethality. Some factors associated with death related to these infections were also identified. A better knowledge of the pathogens involved in CNISs and the predictive factors of death would improve the management of this diseases.