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Published on: October 29, 2014
[Neurological complications and outcomes of bacterial meningitis in children]
O A Milovanova1, L N Mazankova1, D A Moiseenkova2
1Russian Medical Academy of Postgraduate Education, Moscow, Russia; Bashlyaeva Children's City Clinical Hospital, Moscow, Russia.
Insights
Bacterial meningitis (BM) in children can lead to severe brain edema and long-term neurological damage. Early diagnosis and treatment are crucial for better outcomes in pediatric BM cases.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroimaging
Background:
- Bacterial meningitis (BM) is a serious infection affecting the central nervous system in children.
- Neurological complications significantly impact patient outcomes and long-term prognosis.
- Understanding the spectrum of complications is vital for effective management.
Purpose of the Study:
- To investigate the neurological complications and outcomes associated with bacterial meningitis in pediatric patients.
- To correlate specific bacterial pathogens with the incidence and severity of neurological sequelae.
- To identify factors influencing patient outcomes in childhood bacterial meningitis.
Main Methods:
- Retrospective analysis of 55 pediatric patients diagnosed with bacterial meningitis.
- Comprehensive evaluation including bacteriological studies, clinical and biochemical blood tests, serology, and cerebrospinal fluid (CSF) analysis.
- Advanced neuroimaging techniques such as neurosonography, computed tomography (CT), and magnetic resonance imaging (MRI) were employed.
Main Results:
- Generalized meningococcal infection was identified as a significant factor in pediatric BM.
- Brain edema was a frequent and life-threatening complication, observed in varying percentages across different causative agents (meningococcal, pneumococcal, haemophilus).
- While 80% showed no structural brain changes, 20% exhibited residual atrophic or destructive changes post-BM.
Conclusions:
- Bacterial meningitis poses a substantial risk for neurological complications in children, including brain edema and structural brain changes.
- Factors such as complicated premorbid conditions, comorbidities, disease severity, delayed diagnosis, and treatment significantly influence poor outcomes.
- A dissociation between clinical presentation and neuroimaging findings was noted in a considerable proportion of patients, highlighting the complexity of BM management.
Aim:
To analyze neurological complications and outcomes of bacterial meningitis (BM) in children.
Material And Methods:
Fifty-five patients with BM, aged from 2 months to 12 years, were examined. Bacteriological study, clinical and biochemical blood tests and blood serology and cerebrospinal fluid (CSF) tests as well as serum molecular-genetic study were performed. Neuroimaging methods (neurosonography, computed (X-ray) tomography and brain magnetic resonance imaging) were used.
Results And сOnclusion:
A key role of generalized meningococcal infection in the development of BM in children was confirmed. Brain edema was an early and life-threatening complication of BM. It was found in 9% of the patients with meningococcal infection, 7.3% with pneumococcal meningitis and 3.6% with haemophilus meningitis. Changes in the brain structure were not found in 80% of the patients, in 20%, the residual stage of BM was characterized by cerebral destructive/proliferative or atrophic changes of different severity. The dissociation between clinical and neuroimaging parameters and poor outcomes of BM, related to the complicated premorbid state, concomitant somatic/neurological pathology, BM severity, late laboratory diagnosis and untimely etiotropic antibacterial treatment, were identified in 65.5%.
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