Localized extracranial infections in children with acute bacterial meningitis

Twenty-four of 66 (363.6 +/- 116/1000) post-neonatal children with acute bacterial meningitis treated between August 1991 and November 1992 at the Emergency Paediatric Unit, University of Maiduguri Teaching Hospital, Nigeria, had co-existing localized extracranial infections (LEI). Nineteen had bronchopneumonia (of which 14 were in combination with other infections), two had dysentery and one each acute otitis media, orbital cellulitis, and purulent conjunctivitis. LEI were significantly more frequent in children < or = 2 years, and in children with delayed presentation and delayed diagnosis after presentation. Mortality rate was higher in children with LEI (500 +/- 200/1000) than in those without (102.6 +/- 95.2/1000) (P < 0.001). There was no significant relationship between the incidence of LEI and the causative organisms of meningitis or nutritional status of children with meningitis. We conclude that co-existing LEI are not infrequent in children with acute bacterial meningitis; they contribute to delayed diagnosis and are associated with a poorer outcome.