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Risk of bacterial or herpes simplex virus meningitis/encephalitis in children with complex febrile seizures

L Barry Seltz1, Eyal Cohen, Michael Weinstein

  • 1Division of Pediatric Medicine and the Pediatric Outcomes Research Team, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada. leonard.seltz@sickkids.ca

Pediatric Emergency Care
|July 28, 2009
PubMed

Insights

Routine lumbar puncture may be unnecessary for children with complex febrile seizures, as rates of bacterial meningitis and herpes simplex virus (HSV) encephalitis are very low in this population.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neurology

Background:

  • Complex febrile seizures are a common concern in pediatric emergency departments.
  • Distinguishing serious infections like bacterial meningitis and herpes simplex virus (HSV) encephalitis from simple febrile seizures is crucial.

Purpose of the Study:

  • To determine the incidence of bacterial meningitis and HSV encephalitis in children presenting with complex febrile seizures.
  • To evaluate the necessity of routine lumbar puncture in this pediatric population.

Main Methods:

  • Retrospective review of health records for children aged 6 months to 6 years diagnosed with febrile convulsions, meningitis, or encephalitis between 2002 and 2006.
  • Calculation of bacterial meningitis and HSV encephalitis rates in children with complex febrile seizures.

Main Results:

  • Out of 390 encounters with complex febrile seizures, bacterial meningitis was diagnosed in 6 patients (primarily transferred) and HSV encephalitis in 1 transferred patient.
  • For patients initially presenting to the emergency department, the rates were 0.3% for bacterial meningitis and 0.0% for HSV encephalitis.

Conclusions:

  • The incidence of bacterial meningitis and HSV encephalitis is low in children with complex febrile seizures.
  • Routine lumbar puncture may not be necessary for all children presenting with complex febrile seizures, particularly those not transferred from other facilities.
Abstract

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