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Effect of partial treatment on purulent meningitis
Abstract:
Various clinical and laboratory parameters were used for comparing 49 previously untreated and 55 partially treated children with purulent meningitis. The percentage of cases having fever, convulsions, unconsciousness and bulging anterior fontanel was almost the same in both groups. There was no difference in the cellular response and protein content of the cerebrospinal fluid. A Gram smear was positive in 32.6% of untreated and in 47.2% of partially treated patients. Percentages for a positive CSF culture were 38.7 and 50.9%; for CSF sugar of less than 40 mg, 59.1 and 72.7% respectively. The case fatality rate was the same in both groups. These observations suggest that partial treatment neither masks clinical and laboratory findings nor affects the case fatality rate in purulent meningitis in children.
Insights
Partial treatment for purulent meningitis in children did not alter clinical signs or laboratory results. This suggests early intervention does not mask disease presentation or impact outcomes in pediatric bacterial meningitis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Purulent meningitis is a serious infection in children.
- The impact of partial treatment on diagnostic indicators and outcomes is not well understood.
Purpose of the Study:
- To compare clinical and laboratory findings in untreated versus partially treated children with purulent meningitis.
- To assess the effect of partial treatment on the case fatality rate.
Main Methods:
- Retrospective comparison of 49 untreated and 55 partially treated pediatric patients with purulent meningitis.
- Analysis of clinical signs (fever, convulsions, unconsciousness, bulging fontanel), cerebrospinal fluid (CSF) parameters (cell count, protein, Gram smear, culture, sugar levels), and case fatality rates.
Main Results:
- Clinical presentation and CSF cellularity/protein were similar between groups.
- Positive Gram smear and CSF culture rates were higher in partially treated patients.
- Lower CSF sugar levels were more frequent in partially treated children.
- Case fatality rates were identical in both groups.
Conclusions:
- Partial treatment for pediatric purulent meningitis does not mask clinical or key laboratory findings.
- Early or partial antibiotic administration does not appear to influence the case fatality rate in this population.