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Meningitis in children of Riyadh
Insights
This study on pediatric meningitis in Riyadh found high rates of purulent cases, with E. coli and S. pneumoniae as common pathogens. Mortality and neurological deficits were significant, especially in neonates and severely ill children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Meningitis is a significant cause of morbidity and mortality in children.
- Understanding causative organisms and risk factors is crucial for effective treatment.
Purpose of the Study:
- To prospectively study cases of meningitis in children admitted to a Riyadh hospital.
- To identify common pathogens, clinical features, and outcomes.
- To analyze factors associated with mortality and neurological sequelae.
Main Methods:
- Prospective study of 140 pediatric meningitis cases over two years (1980-1982).
- Analysis of cerebrospinal fluid (CSF) for causative organisms.
- Assessment of patient demographics, clinical presentation, treatment, and outcomes.
Main Results:
- 88.6% of cases had purulent meningitis; common pathogens included E. coli (neonates) and S. pneumoniae.
- Significant mortality (20%) and neurological deficits (28%) were observed.
- Neonates, comatose patients, those with pre-admission treatment, and late presenters had higher mortality and sequelae.
Conclusions:
- Pediatric meningitis in Riyadh presented with high rates of bacterial infection and poor outcomes.
- Prompt diagnosis and treatment are critical, especially for high-risk groups.
- Antimicrobial resistance patterns, particularly for H. influenzae, require ongoing monitoring.
Abstract:
One hundred and forty cases of meningitis admitted to the Children's Hospital in Riyadh from June 1980 to the end of May 1982 were included in a prospective study. Sixty-seven percent were under 1 year of age and 90% were under 5 years old. One hundred and twenty-four (88.6%) had purulent CSF, 12 (8.6%) had viral and four (2.9%) had tuberculous meningitis. E. coli was the commonest causative organism in the neonates. After that age S. pneumoniae was the predominant isolate. The implication of increasing resistance of H. influenzae to ampicillin therapy were discussed and a further rare case of meningitis caused by Flavobacterium meningosepticum was described. Seventy-three (52%) were cured completely, 39 (28%) survived with immediate neurological deficits and 28 (20%) died. Mortality and neurological sequelae were found to be high in four categories of patients: neonates, patients who were stuporose or comatose on admission, those who were partially treated before admission and those who presented late after the onset of their symptoms.