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Updated: Mar 10, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Clinical analysis on 430 cases of infantile purulent meningitis
Zhihui He1, Xiujuan Li1, Li Jiang1
1Department of Neurology, Children's Hospital, Chongqing Medical University, 136 Second Zhongshan Road, Chonqqing, 400014 People's Republic of China.
Background:
Purulent meningitis (PM) usually caused by a variety of pyogenic infection, is a kind of central nervous system infectious disease mostly common in children. It is easily misdiagnosed and its symptoms are varied. Excessive application of broad-spectrum antibiotics results in increased sickness and death of infants and young children. In this study, clinical data of 430 cases of PM in infants were analyzed to summarize the clinical experiences so as to achieve early diagnosis and early treatment of PM.
Results:
Male-to-female ratio was 1.61:1, and the median age of incidence was 0.42 years. May was the modal month of onset (11.7%). Main clinical manifestations were fever (89.3%), vomiting (67.2%), mental fatigue (62.1%), anterior fontanelle full/bulging/high tension (54.2%), convulsion (52.6%), and meningeal irritation sign (24.7%). Cerebrospinal fluid (CSF) bacterial culture was done for 420 cases, of which 1.2% cases were positive. Blood culture was done for 146 cases of which 15.1% were positive. 175 (40.7%) cases had complications, among which 133 cases (76.0%) were subdural effusion, 21 cases (12.0%) were epilepsy.
Conclusion:
Infantile PM is common in Spring, and May is the modal month of onset. The CSF/blood pathogen detection rate is very low and it is difficult to find evidence of cause. Fever, vomiting, mental fatigue and anterior fontanelle full/bulging/high tension, convulsion are the main clinical manifestations on which diagnosis depends. For those children diagnosed as PM and still having recurrent fever and prominent anterior fontanelle after treatment, clinicians should consider the probability of subdural effusion and treat them with brain imaging test on time.
Insights
Purulent meningitis in infants often presents with fever and vomiting, and diagnosis relies on clinical signs due to low pathogen detection rates. Suspect subdural effusion in persistent cases and use brain imaging for timely treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Purulent meningitis (PM) is a serious central nervous system infection common in children.
- Infantile PM is challenging to diagnose due to varied symptoms and is often misdiagnosed.
- Overuse of broad-spectrum antibiotics contributes to increased morbidity and mortality in infants.
Purpose of the Study:
- To analyze clinical data of 430 infants with purulent meningitis.
- To summarize clinical experiences for early diagnosis and treatment of infantile PM.
- To identify key clinical manifestations and complications of infantile purulent meningitis.
Main Methods:
- Retrospective analysis of clinical data from 430 infants diagnosed with purulent meningitis.
- Evaluation of clinical manifestations, laboratory results (CSF and blood cultures), and complications.
- Assessment of treatment outcomes and diagnostic challenges.
Main Results:
- The median age of incidence was 0.42 years, with May being the modal month of onset.
- Common symptoms included fever (89.3%), vomiting (67.2%), mental fatigue (62.1%), and bulging fontanelle (54.2%).
- Pathogen detection rates were low (CSF: 1.2%, Blood: 15.1%); subdural effusion (40.7%) and epilepsy (12.0%) were common complications.
Conclusions:
- Infantile PM peaks in Spring, with May as the most common onset month.
- Low pathogen detection rates necessitate diagnosis based on clinical signs like fever, vomiting, and bulging fontanelle.
- Subdural effusion should be considered in persistent cases, warranting timely brain imaging.
