[Clinical analysis of purulent meningitis in 317 children].

Abstract

OBJECTIVE:

To study the clinical features, treatment, and prognosis of purulent meningitis (PM) in children.

METHODS:

A retrospective analysis was performed on the clinical data of 317 children with PM aged from 1 month to 15 years.

RESULTS:

PM was commonly seen in infants (198 cases, 62.6%). Most children with PM had preceding respiratory infection (171 cases, 53.9%). The major clinical manifestations of PM were fever, convulsions, and intracranial hypertension, and convulsions were more commonly seen in infants (152 cases, 93.6%). The major complication was subdural effusion (95 cases, 29.9%). Of the 95 cases of subdural effusion, 22 cases were diagnosed by subdural puncture; 68 cases underwent subdural puncture and 62 cases restored to normal temperature 3-5 days after puncture. Risk factors associated with complications and sequelae were young age and protein≥1 g/L in cerebrospinal fluid (CSF) (OR=0.518, 1.524 respectively; P<0.05). The third-generation cephalosporins were the first choice for PM, and vancomycin or carbapenems were replacement therapy. Thirteen (14.4%) out of 90 children had delayed cerebral vasculitis during a follow-up visit within 3 months after discharge.

CONCLUSIONS:

PM is more commonly seen in infants, and the infants have a high incidence of convulsions. Young age and protein≥1 g/L in CSF may increase the risk of complications and sequelae. Subdural puncture is not only a diagnostic method but also a therapy for subdural effusion. Some children have delayed cerebral vasculitis during a follow-up visit within 3 months after discharge, so follow-up visits should be performed within 3 months after discharge.

• Authors: Qing-Qing Xu, Mei Li
• Journal: Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics (Zhongguo Dang Dai Er Ke Za Zhi) Vol. 17 Issue 7 Pg. 710-4 (Jul 2015) ISSN: 1008-8830 [Print] China
• PMID: 26182277 (Publication Type: English Abstract, Journal Article)

Topics

• Adolescent
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Infant
• Male
• Meningitis, Bacterial (complications, drug therapy, microbiology)
• Suppuration (microbiology)