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Association of meningitis with infantile gastro-enteritis

I Al-Jo'beh, H Nazer

    Annals of Tropical Paediatrics
    |December 1, 1986
    PubMed

    Insights

    Lumbar puncture is frequently performed on children with gastroenteritis, but acute bacterial meningitis is rare. The study suggests reserving lumbar puncture for children with persistent central nervous system (CNS) abnormalities or clear meningitis signs.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Neurology

    Background:

    • Jordan University Hospital policy mandates lumbar puncture for children with gastroenteritis presenting with specific neurological signs or age < 1 month.
    • Gastroenteritis in children can present with symptoms that overlap with central nervous system (CNS) infections, leading to diagnostic uncertainty.

    Purpose of the Study:

    • To evaluate the diagnostic yield of lumbar puncture in children admitted with gastroenteritis at Jordan University Hospital.
    • To reassess the current hospital policy regarding lumbar puncture in pediatric gastroenteritis cases.

    Main Methods:

    • Retrospective review of medical records for 737 children admitted with gastroenteritis between January 1980 and October 1984.
    • Analysis of the incidence of acute bacterial meningitis in children who underwent lumbar puncture.

    Main Results:

    • Lumbar puncture was performed on 351 (47.6%) of the 737 children admitted with gastroenteritis.
    • Acute bacterial meningitis was diagnosed in only three children (0.85% of all gastroenteritis admissions).
    • Two of the three meningitis cases had received prior treatment, and the third presented with obvious meningeal signs.

    Conclusions:

    • The current policy of performing lumbar puncture on a broad range of children with gastroenteritis is not supported by the low incidence of acute bacterial meningitis.
    • It is recommended to reserve lumbar puncture for pediatric gastroenteritis patients with persistent CNS abnormalities after fluid/electrolyte correction or overt signs of meningitis.

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