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Cerebral infarction in perinatal and childhood bacterial meningitis

C-J Chang1, W-N Chang, L-T Huang

  • 1Department of Pediatric Neurology, Chang Gung Memorial Hospital-Kaohsiung, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan.

QJM : Monthly Journal of the Association of Physicians
|September 23, 2003
PubMed

Insights

Cerebral infarction is a serious complication of bacterial meningitis in children, particularly in infants. Risk factors include seizures, hydrocephalus, and high CSF lactate, with a poor prognosis for affected infants.

Area of Science:

  • Neurology
  • Pediatrics
  • Infectious Diseases

Background:

  • Cerebral infarction is a significant neurological complication of childhood bacterial meningitis.
  • Limited information exists regarding the epidemiology and outcomes of this condition.

Purpose of the Study:

  • To identify predictive factors, clinical features, causative pathogens, and outcomes of cerebral infarction in perinatal and childhood bacterial meningitis.
  • To analyze risk factors associated with cerebral infarction in pediatric meningitis patients.

Main Methods:

  • Retrospective analysis of 166 patients with culture-proven bacterial meningitis from 1986-2001.
  • Comparison of clinical and cerebrospinal fluid (CSF) data between patients with and without cerebral infarction at admission.

Main Results:

  • Cerebral infarction occurred in 10% of bacterial meningitis cases, predominantly in infants under one year old (79%).
  • Salmonella species and Streptococcus pneumoniae were the most common pathogens (57%).
  • Poor outcomes were observed in 11 out of 14 patients at one-year follow-up.

Conclusions:

  • Cerebral infarction is highly prevalent with S. pneumoniae and Salmonella meningitis, especially in infants.
  • Risk factors include age (28-365 days), seizures, hydrocephalus, altered consciousness, and elevated CSF lactate.
  • The prognosis for infants with cerebral infarction due to bacterial meningitis is poor.
Abstract

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