Clinical analysis of purulent meningitis in 317 children.
- Author:
Qing-Qing XU
1
;
Mei LI
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Male; Meningitis, Bacterial; complications; drug therapy; microbiology; Suppuration; microbiology
- From: Chinese Journal of Contemporary Pediatrics 2015;17(7):710-714
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo study the clinical features, treatment, and prognosis of purulent meningitis (PM) in children.
METHODSA retrospective analysis was performed on the clinical data of 317 children with PM aged from 1 month to 15 years.
RESULTSPM 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.
CONCLUSIONSPM 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.