Citation Information :
Raj KA, Bhat YR, Kini P, Aroor S. Clinical Profile, Cerebrospinal Fluid Findings, and Outcome of Acute Meningitis in Children: A Recent Audit from a Tertiary Center in India. Pediatr Inf Dis 2021; 3 (4):135-139.
Aim and objective: Periodic surveillance of causative organisms of acute meningitis in children is helpful. Cerebrospinal fluid (CSF) findings characterize the type of meningitis and guide therapy to improve the outcome. We aimed to analyze clinical features, CSF characteristics, causative organisms, and the outcome of meningitis in children.
Materials and methods: Children aged from 1 month to 18 years admitted to a teaching hospital with a provisional diagnosis of meningitis were studied retrospectively. Clinical data, CSF analysis, and complications of meningitis were retrieved from medical records. Meningitis was further classified depending on laboratory findings into acute bacterial meningitis (ABM), probable bacterial meningitis (APBM), and aseptic meningitis (ASM).
Results: Among 50 children with meningitis, 9 (18%) had ABM, 34 (68%) had APBM, and 7 (14%) had ASM. The causative bacteria included Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli, Enterobacter cloacae, Streptococcus viridians, Brucella, and Salmonella typhimurium. Important clinical features included fever (96%), seizures (50%), headache (44%), vomiting (70%), altered sensorium (56%), neck stiffness (56%), cranial nerve palsy (16%), and focal neurological deficits (10%). The median CSF WBC levels in ABM, APBM, and ASM groups were 310, 125, and 140 cells/mm3, respectively. The mean CSF glucose and protein levels in the same groups, respectively, were 29.5 ± 23.1, 51.2 ± 23.8, and 51.7 ± 8.7 mg/dL; and 441.5 ± 546.9, 99.1 ± 79.1, and 100.1 ± 82.6 mg/dL. Complications among 43 bacterial meningitis included hydrocephalus (8, 18.6%), hearing loss (4, 9.3%), visual impairment (3, 6.9%), brain abscess (3, 6.9%), subdural effusion (1, 2.3%), and infarct (1, 2.3%).
Conclusion: The present study has explored the causative bacteria in acute meningitis in children. Furthermore, the study explored the characteristics of CSF and identified the important complications.
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