Publication: Culture Proven Bacterial Meningitis in Children: Agents, Clinical Profile and Outcome
Date
2011
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu Unversity
Abstract
ABSTRACT
Background
Meningitis is a serious infection. Little is known about the bacterial agents and their
antibacterial sensitivity in Nepalese children.
Objectives
To study bacteriological agents, clinical profile and immediate outcome in patients
admitted to children’s ward of Patan Hospital with meningitis.
Methods
Prospective observational study conducted in paediatric ward of Patan Hospital. All
the children admitted to the ward, with the diagnosis of culture proven bacterial
meningitis’ on discharge were eligible.
Results
Out of 7,751 children, 296 (3.8%) had meningitis. This was a group ranging from
neonates to adolescents aged 18 years. Only 13 (4.4%) of cerebrospinal fluid
samples taken from them yielded positive culture reports. The organisms were
pneumococcus (6), Haemophilus influenza ‘b’ (3), β-hemolytic Streptococcus (1),
α-hemolytic Streptococcus (1), N. meningitides (1) and Pseudomonas (1). Whereas
Haemophilus influenza ‘b’ was isolated from young infants, pneumococci were
found in the young as well as the old. Fever, vomiting, high leukocyte count with left
shift were all commonly present. All but one had cerebrospinal fluid pleocytosis.
Low sugar and high protein was found in most specimens. Neuroimaging was done
in six children of which three were abnormal (all young infants and pneumococci
cases). Ceftriaxone was given to all but one child. Everybody recovered but three
had complications – profound hearing loss and cortical atrophy with subdural
collection in pneumococcal and septic arthritis with persistence of fever in
Haemophilus influenzae ‘b’ meningitis.
Conclusion
The present study corroborates most of the epidemiological and clinical features
of acute bacterial meningitis and sheds light on the causative agents of bacterial
meningitis in Nepalese children.
KEY WORDS
antibiotics, CSF, meningitis, pneumococcus
Description
Ansari I, Pokhrel Y
Department of Pediatrics Patan Academy of Health Sciences, Patan Hospital Lagankhel, Lalitpur; Nepal