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A profile of pyogenic meningitis in children
B V Bhat1, I C Verma, R K Puri
1Department of Paediatrics, Jawaharial Institute of Postgraduate Medical Education and Research, Pondicherry.
Insights
Pyogenic meningitis in young children often presents atypically. Early diagnosis with high suspicion is crucial to reduce severe outcomes and fatalities from this serious infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Pyogenic meningitis is a significant cause of morbidity and mortality, particularly in infants and young children.
- Typical clinical presentations may be absent in pediatric cases, complicating early diagnosis.
Purpose of the Study:
- To describe the clinical profile of pyogenic meningitis in a pediatric cohort.
- To identify key diagnostic challenges and inform strategies for early detection.
Main Methods:
- Retrospective analysis of 256 cases of pyogenic meningitis over an 8-year period.
- Evaluation of demographic data, presenting symptoms, and cerebrospinal fluid (CSF) analysis.
Main Results:
- The majority of patients (83.6%) were under 3 years old, with a male predominance.
- Common symptoms included fever, altered sensorium, feeding refusal, and vomiting; however, atypical signs like subnormal temperature and normal sensorium were observed.
- Cerebrospinal fluid findings were often non-specific, with a significant proportion showing normal or near-normal parameters.
- Diplococcus pneumoniae was the most frequent pathogen identified.
- Overall mortality rate was 30.5%.
Conclusions:
- Young children with pyogenic meningitis frequently exhibit non-classical symptoms, necessitating a high index of suspicion for timely diagnosis.
- Early and accurate diagnosis is vital to mitigate the high rates of morbidity and mortality associated with pediatric pyogenic meningitis.
Abstract:
Clinical profile of pyogenic meningitis was studied in 256 cases over a period of 8 years. The male to female ratio was 1.46: 1 and 83.6% of the patients were less than 3 years of age. Fever, altered sensorium, refusal to feed, convulsions and vomiting were the common presenting symptoms. Six (2.3%) of them had subnormal temperature and the sensorium was normal in 12.5% of cases. Cerebrospinal fluid was clear in 9.4%, cell count was less than 100/cmm in 8.2%, sugar was more than 40 mg% in 24.2% and protein was less than 50 mg% in 12.5% of cases. Diplococcus pneumoniae was the commonest causative agent. The overall mortality was 30.5%. It is concluded that young children suffering from this disease may not have the typical features and one should have the highest suspicion to make an early diagnosis so that the morbidity and mortality from this condition can be reduced.