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Childhood bacterial meningitis in Saudi Arabia
1Department of Paediatrics, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
Insights
Childhood bacterial meningitis is primarily caused by Haemophilus influenzae type b. Early vaccination against H. influenzae type b is strongly recommended to prevent this serious infection in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Childhood meningitis remains a significant public health concern.
- Understanding the causative agents and outcomes is crucial for effective management.
Purpose of the Study:
- To analyze the bacterial causes and clinical outcomes of childhood meningitis.
- To identify the predominant pathogens and associated complications.
- To evaluate the impact of steroid therapy on hearing loss in Haemophilus influenzae meningitis.
Main Methods:
- Retrospective chart review of 70 children diagnosed with bacterial meningitis over 11 years.
- Identification of aetiological organisms through laboratory analysis.
- Assessment of clinical presentation, complications, and treatment outcomes.
Main Results:
- Haemophilus influenzae (66%) was the leading cause, followed by Streptococcus pneumoniae (24%).
- Common symptoms included fever (86%), vomiting (29%), and poor feeding (19%).
- Complications such as subdural effusion (23%) and hearing loss (14%) were frequent. Steroid use showed a potential protective effect against hearing loss in H. influenzae cases.
Conclusions:
- Haemophilus influenzae type b is the predominant cause of bacterial meningitis in children in Saudi Arabia.
- Universal vaccination against H. influenzae type b is highly recommended.
- Further research into optimal treatment strategies, including steroid use, is warranted.
Abstract:
This study analysed the bacterial aetiology and outcome of childhood meningitis observed over an 11-year period. Charts of 70 children with this diagnosis were reviewed. Three children were under 1 month of age, five were between 1 and 3 months and 60 were between 3 months and 5 years. The remaining two were over 5 years. There were 36 females and 34 males. The presenting symptoms in decreasing order of frequency were fever 86%, vomiting 29%, poor feeding 19%, seizure 14% and lethargy 14%. Aetiological organisms were as follows: Haemophilus influenzae 66%, Streptococcus pneumoniae 24%, Neisseria meningitidis 4%, Group B Streptococci 4%, and Staphylococcus aureus 2%. All H. influenzae isolates except one were sensitive to ampicillin. None of the S. pneumoniae isolates were resistant to penicillin. Complications occurred in 26% of the patients and included subdural effusion 23%, hearing loss 14%, seizure disorder 10%, developmental delay 9%, hydrocephalus 6% and motor deficit 30%. One patient died. Among H. influenzae cases, one of the 15 patients treated with steroids developed hearing loss. In contrast, four out of 31 who did not receive steroid therapy suffered from hearing loss. Haemophilus influenzae type b is the predominant cause of childhood bacterial meningitis in Saudi Arabia. Universal H. influenzae type b vaccination for children is highly recommended.