Abstract Details

Title A Dedicated Neurological Infectious Disease Consult Service: One Year of Experience

Topic Infections/AIDS/Prion Disease

Presentation(s) P04 - (-)

Poster/Presentation
Number 016

Objective

Background BACKGROUND: Neuro-infectious diseases are often complex, misdiagnosed or undiagnosed. If left undiagnosed, they have significant morbidity and mortality. The establishment of a subspecialty such as the Neurological Intensive Care Unit (NICU) resulted in improved care and outcomes. Few institutions have implemented a dedicated inpatient NID service.

Design/Methods DESIGN/METHODS: Retrospective review of all patients consulted to the NID service between March 2011 and March 2012 at our center. Demographic data, consulting service, reason for consult, laboratory and vitals, final diagnosis and clinic follow up notes were reviewed.

Results RESULTS: In one year, there were 383 NID consults done in 364 patients. Mean age was 53 with a standard deviation of 17 years. There were 181 males (50%). Neurosurgery was the most common consulting service (46%) followed by Neurology (22%), and Internal Medicine (16%). Suspected acute meningitis was the most common reason for consult (27.23%) followed by suspected central nervous system (CNS) abscess (18.72%), suspected encephalitis/myelitis (18.3%), and altered mental status with fever (11.1%). Fever (>38 C) was seen in 47%. CSF pleocytosis (>5 cells) in 63% and CSF hypoglycorrhachia in 12%. In 98% of the consults, a final diagnosis was made. Most commonly, a non-infectious CNS disease process that mimicked an infection was diagnosed (21%) followed by a diagnosis of CNS abscess (13%) and encephalitis (13%). The most common non-infectious CNS disease was demyelinating/auto-immune disorder.

Conclusions CONCLUSIONS: In most patients seen by the NID service a final diagnosis was reached. The most common diagnoses were non-ID CNS diseases that mimic an infection. Knowledge of these mimics is important in approaching these patients. The implementation of a dedicated NID service can result in accurate diagnosis.

Authors/Disclosures
Pravin George, DO (Cleveland Clinic) PRESENTER	Dr. George has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Adarsh Bhimraj, MD (Cleveland Clinic)	Dr. Bhimraj has nothing to disclose.

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