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Prognosis of bacterial meningitis in children
1Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brasil.
Insights
Acute bacterial meningitis in children causes significant neurologic issues and has a high mortality rate, especially when the causative agent is identified. Early detection and public health interventions are crucial for better outcomes.
Area of Science:
- Pediatrics
- Neurology
- Infectious Diseases
Background:
- Acute bacterial meningitis remains a critical health concern, particularly in developing nations.
- Neurologic complications significantly impact patient prognosis and long-term outcomes.
Purpose of the Study:
- To investigate the incidence and prognosis of acute neurologic complications in pediatric patients diagnosed with acute bacterial meningitis.
- To identify factors associated with increased lethality in this patient population.
Main Methods:
- A cohort of 281 children under 13 with acute bacterial meningitis underwent standardized daily neurological examinations.
- Brain computer tomography was performed for patients with encephalic lesions, poor antibiotic response, or decreased consciousness.
Main Results:
- The overall lethality rate was 20.3%, with a higher rate (23.7%) when the causative agent was identified.
- Common neurological abnormalities included meningeal signs (88.3%), decreased consciousness (47.7%), and seizures (22.4%).
- Seizures, cranial nerve palsy, and absence of meningeal signs correlated with higher mortality.
Conclusions:
- Acute bacterial meningitis poses a substantial public health challenge in developing countries.
- Effective public health measures are essential to mitigate sequelae and reduce mortality rates in affected children.
Abstract:
We studied the incidence and prognosis of acute neurologic complications in 281 children under 13 years of age with a diagnosis of acute bacterial meningitis. All the patients were examined daily by the same group of neurologists, using a standardized neurological examination. Patients with signs of encephalic lesions, unsatisfactory response to antibiotics or decreased level of consciousness were submitted to brain computer tomography. The overall lethality rate was 20.3% and cases whose causative agent was identified presented a higher lethality rate (23.7%) than those in which the agent was not found. The most important neurological abnormalities were meningeal signs (88.3%) followed by decreased consciousness (47.7%), irritability (35.2%), seizures (22.4%), fontanel bulging (20.6%) and cranial nerve palsy (14.2%). Seizures, cranial nerve palsy and the absence of meningeal signs were related to higher rates of lethality. Diminished consciousness, seizures, subdural effusion, abscess and hydrocephalus were the most important complications, respectively. We can conclude that acute bacterial meningitis continues to be an important health problem in developing countries and that public health measures will be necessary to minimize the impact of sequelae and reduce the mortality rate in children with that pathology.