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Inappropriate secretion of antidiuretic hormone in acute bacterial meningitis

A K Patwari1, B S Singh, D E Manorama

  • 1Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India.

Annals of Tropical Paediatrics
|June 1, 1995
PubMed

Insights

Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) affects over a third of children with bacterial meningitis, significantly increasing mortality. Early diagnosis and management are crucial for improving outcomes in these severe cases.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Endocrinology

Background:

  • Bacterial meningitis is a serious infection in children.
  • Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) is a potential complication.
  • The incidence and impact of SIADH in pediatric meningitis require further investigation.

Purpose of the Study:

  • To determine the incidence of SIADH in children with acute bacterial meningitis.
  • To describe the clinical manifestations and outcomes of SIADH in this population.
  • To identify factors associated with SIADH and its impact on mortality.

Main Methods:

  • Prospective study of 60 children (1 month-12 years) with acute bacterial meningitis.
  • Serum sodium, serum osmolality, and urine osmolality measured on admission, day 3, and day 10.
  • Correlation analysis to assess relationships between SIADH, clinical factors, and outcomes.

Main Results:

  • SIADH diagnosed in 36.7% of cases on admission and 12.5% on day 3.
  • Mortality was significantly higher in children with SIADH (p < 0.001).
  • SIADH incidence was highest with Streptococcus pneumoniae (75%) and Haemophilus influenzae (57.1%).

Conclusions:

  • SIADH is a common and serious complication of pediatric bacterial meningitis.
  • SIADH is associated with increased mortality, particularly in the first 72 hours.
  • Prompt recognition and management of SIADH are critical for improving survival rates in children with meningitis.

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