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[Bacterial meningitis in children. Analysis of 181 cases]
Insights
Bacterial meningitis in children, particularly from six months to three years, peaked in winter/spring. Despite frequent negative cultures and prior antibiotic use, common complications included septic shock and seizures, with deafness as a sequela.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Epidemiology
Context:
- Bacterial meningitis remains a significant cause of childhood morbidity and mortality.
- Understanding causative agents, risk factors, and outcomes is crucial for effective management.
- This study analyzes clinical data from a cohort of children diagnosed with bacterial meningitis.
Purpose:
- To describe the clinical features, causative agents, and outcomes of bacterial meningitis in children.
- To identify peak incidence periods and common complications.
- To assess long-term sequelae and compare outcomes between affected children and a control group.
Summary:
- A retrospective review of 181 children (1 month to 7 years) with bacterial meningitis from 1978-1982.
- Peak incidence was observed in children aged 6 months to 3 years, during January-May.
- Neisseria meningitidis (35%), Streptococcus pneumoniae (4.9%), and Haemophilus influenzae (2.7%) were most common; CSF cultures were negative in 56% due to prior antibiotic use.
- Complications included septic shock (11%), seizures (6.6%), and subdural effusion (2.2%). Permanent sequelae, predominantly deafness (3.8%), were noted.
- Mortality was 6.3%, often linked to meningococcal sepsis and endotoxic shock.
Impact:
- Highlights the persistent challenge of bacterial meningitis in pediatric populations.
- Underscores the importance of early diagnosis and management despite diagnostic difficulties (e.g., negative CSF cultures).
- Provides data on long-term sequelae, informing prognosis and rehabilitation needs for affected children.
Abstract:
Clinical records of 181 children, aged between one month and seven years, admitted in a four year period, from 1978 through 1982, with the diagnosis of bacterial meningitis are revised. Peak incidence occurred in the age group between six months and three years, and during the months of January to May. N. meningitidis (35%), pneumococcus (4.9%) and H. influenzae (2.7%) were the most frequently isolated bacteria. CSF culture was negative in 56% of the children. All of them had previously taken antibiotics. Complications were present in 6.4%, with highest incidence in the known-agent group, on the following order: septic shock, 11%, seizures, 6.6%, and subdural effusion, 2.2%. Permanent sequelae were present in 3.8%, being deafness predominant. Twelve (6.3%) out of the 181 died, and death was result of fulminant meningococcal sepsis with endotoxic shock in ten of these patients. Clinical and psychological followed-up of twenty-nine children with isolated causal agent, were compared with a control group, finding no statistically-significant difference.