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Pyogenic meningitis in hospitalized children in Kelantan, Malaysia
K E Choo1, W A Ariffin, T Ahmad
1Department of Paediatrics, Hospital Universiti Sains Malaysia, School of Medical Sciences, Kubang Kerian.
Insights
This study on pediatric pyogenic meningitis in Kelantan found Haemophilus influenzae and Streptococcus pneumoniae as leading causes, with high mortality in infants. Chloramphenicol and penicillin showed excellent sensitivity against these pathogens.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Pyogenic meningitis poses a significant threat to hospitalized children.
- Understanding the etiology, clinical presentation, and outcomes is crucial for effective management.
Purpose of the Study:
- To investigate the aetiology, clinical features, investigations, treatment, and outcomes of pyogenic meningitis in hospitalized children.
- To determine antibiotic sensitivity patterns for common causative agents.
Main Methods:
- A 2.5-year retrospective study of 58 hospitalized children diagnosed with pyogenic meningitis.
- Analysis of clinical data, cerebrospinal fluid (CSF) cultures, and antibiotic sensitivity testing.
Main Results:
- Haemophilus influenzae (50%) and Streptococcus pneumoniae (22.4%) were the most frequent bacterial causes.
- Fever, fits, and anorexia were common presenting symptoms; coma was noted in 55.2% on admission.
- Hospital mortality was 18.9%, predominantly in infants (<1 year).
- Antibiotics like Chloramphenicol, penicillin, and ampicillin demonstrated high sensitivity against the identified pathogens.
- Neurological sequelae were observed in 47.4% of evaluated survivors.
Conclusions:
- Pediatric pyogenic meningitis, particularly in infants, remains a serious condition with significant mortality and morbidity.
- Prompt diagnosis and appropriate antibiotic therapy based on sensitivity profiles are essential.
- Long-term neurological sequelae highlight the need for comprehensive patient care and follow-up.
Abstract:
A 2.5-year retrospective study of pyogenic meningitis in hospitalized children in Kelantan was carried out with regard to aetiology, clinical features, investigation, treatment and outcome. There were 58 children with 43 cases (74.1%) occurring below the age of 1 year. Frequent presenting symptoms included fever (98.3%), fits (77.6%), anorexia (39.7%), vomiting (34.5%) and drowsiness (12.1%). On admission, 37 (63.7%) had neck stiffness, 10 (17.2%) had Kernig's sign and 32 (55.2%) had coma. CSF cultures were positive for Haemophilus influenzae in 29 (50%), Streptococcus pneumonia in 13 (22.4%) and Neisseria meningitidis in 3 (5.2%). The antibiotic sensitivity profiles showed that the three main organisms were 100% sensitive to Chloramphenicol, Streptococcus pneumoniae was 100% sensitive to penicillin, Neisseria meningitidis was 100% sensitive to penicillin and ampicillin, and Haemophilus influenzae was 90% sensitive to penicillin and ampicillin. The total hospital mortality was 18.9%. All but two of the eleven deaths occurred in children younger than 1 year. Nineteen of the 35 (54.3%) survivors attended for at least one follow-up after discharge from hospital. Of these 19 children, 47.4% had neurological sequelae.