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[Bacterial meningitis in neonates]
1Department of Pediatrics, China Medical College Hospital, Taichung, Taiwan, R.O.C.
Insights
Neonatal meningitis, predominantly caused by E. coli, had a 22.2% fatality rate. Survivors faced significant sequelae, including hydrocephalus, highlighting the severity of this infection in newborns.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatrics
Context:
- Retrospective analysis of 27 neonatal meningitis cases treated between 1981-1988.
- Included premature and full-term infants, with a focus on early-onset cases.
Purpose:
- To describe clinical features and management of neonatal meningitis.
- To identify risk factors and outcomes associated with the condition.
Summary:
- Escherichia coli (E. coli) was the primary pathogen identified.
- Common symptoms included fever, poor feeding, respiratory distress, and lethargy.
- Mortality rate was 22.2%, with 19% of survivors experiencing sequelae like hydrocephalus.
Impact:
- Highlighting the significant mortality and morbidity associated with neonatal meningitis.
- Identifying gram-negative bacterial infection and high cerebrospinal fluid protein as indicators of poorer outcomes.
- Informing clinical management and prognosis for affected newborns.
Abstract:
A retrospective study of the clinical features and management of 27 newborns with meningitis is presented. All were treated in the China Medical College Hospital between July 1981 and July 1988. Seven were premature and twenty were full term. There were 11 males and 16 females. Five infants had low birth weight (less than 2500 g) and 12 cases were diagnosed in the first week of life (early onset). E.coli was the predominant pathogen. The most common presenting manifestations were nonspecific in nature-fever, poor feeding, respiratory distress and poor activity, etc... Six patients died during the period of acute illness and the case fatality rate was 22.2%. Of the 21 patients who survived, six had sequelae (four hydrocephalus, one subdural effusion, one microcephaly), giving an over-all rate of 19 percent in the survivors. The presence of gram-negative bacterial infection and high protein content in CSF correlated significantly with the higher mortality rate.