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[Pneumococcal meningitis in the infantile population of Cantabria]
J Alonso Palacio1, V Madrigal Díez, M García Fuentes
1Departamento de Pediatría, Hospital Nacional Marqués de Valdecilla, Facultad de Medicina, Santander.
Insights
This retrospective study of pneumococcal meningitis in pediatric patients found that high CSF protein and low glucose levels indicate severe illness. Early diagnosis and treatment are crucial for better outcomes in pediatric meningitis cases.
Area of Science:
- Pediatric Infectious Diseases
- Neurology
- Epidemiology
Context:
- Pneumococcal meningitis remains a significant cause of morbidity and mortality in children.
- Understanding the clinical presentation and risk factors is crucial for effective management.
- This study analyzes cases from Cantabria, Spain, spanning a 14-year period.
Purpose:
- To retrospectively analyze cases of pneumococcal meningitis in pediatric patients.
- To identify clinical characteristics, risk factors, and outcomes associated with pneumococcal meningitis.
- To determine the most useful analytical indicators for predicting disease severity.
Summary:
- The study reviewed 22 cases of pneumococcal meningitis in 17 pediatric patients (0.3-14 years) from 1977-1990.
- Underlying pathologies were present in 63.6% of cases, and antibiotic resistance was noted in 4 instances.
- Complete recovery occurred in 86.4% of cases; elevated CSF protein and absent CSF glucose were key indicators of severity.
Impact:
- Highlights the importance of identifying underlying conditions that predispose children to meningitis.
- Emphasizes the prognostic value of cerebrospinal fluid (CSF) protein and glucose levels.
- Provides valuable data for clinicians managing pediatric pneumococcal meningitis, informing treatment and prognosis.
Abstract:
A retrospective study of pneumococcal meningitis was carried out. This study included 22 cases of this illness that occurred in 17 pediatric patients in Cantabria between 1977 and 1990, inclusive. Three children suffered from recurrent meningitis. The age range of the patients was 0.3-14 years, with a mean age of 4 years. Of these cases, 77.4% occurred in the winter or spring. In 14 cases of meningitis (63.6%), corresponding to 9 patients, underlying pathology was observed: cranial fracture, occipital dermoid cyst, splenectomy, congenital cardiopathy, epilepsy and gastroduodenal "situs inversus". The isolated pneumococci were found to be resistant to penicillin and chloramphenicol in 4 cases. One patient suffered from septic shock. The outcome was complete recovery in 19 cases (86.4%), recovery with sequelae (deafness and epilepsy, respectively) in 2 cases (9.1%) and death in another 2 cases. CSF protein levels elevated above 150 mg/dl and the absence of glucose in the CSF were found to be the most useful analytical indicators of the seriousness of the illness.