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Early complications of acute bacterial meningitis in children beyond neonatal period

Author: 
Dr. Lamyaa Imran Ali, Dr. Abdulrahman Ismael Dakhel and Dr. Tareq Kannan Mohammed
Subject Area: 
Social Sciences and Humanities
Abstract: 

Background: Bacterial meningitis continues to be a serious, often disabling infectious disease, during the acute onset of meningitis, acute CNS complications can include seizures, increased intracranial pressure, cranial nerve palsies, stroke,cerebral or cerebellar herniation, and thrombosis of the dural venous sinuses, Long-term sequelae of meningitis result from direct inflammatory destruction of brain cells, vascular injuries, or secondary gliosis. Focal motor and sensory deficits, visual impairment, hearing loss, seizures, hydrocephalus, and a variety of cranial nerve deficits can result from meningitis, In addition to the variety of disorders mentioned earlier in this section; some patients with meningitis have mental retardation and severe behavioral disorders that limit their function at school and later performance in life. Aim of study • Early detection of possible post-meningitis complication. • To find the prognostic factors of those complication. Patient and method: Among one hundred twenty-three patients selected, One hundred fifteen patients enrolled in study after they met inclusion criteria, they are aged 1 month to 15 years, admitted to infectious department at Central teaching hospital of pediatrics in Baghdad/Iraq with acute bacterial meningitis, followed up after discharge over a 12 month period. Data were collected from the infectious follow up clinic in our center, Various data collected from history, examination, and investigation results for comparison to show the risk factors associated with developing complications. Results: Among one hundred fifteen cases enrolled in the study, Benign course patients (patients who developed no sequelae after meningitis) were 60 in number, complicated course patients were 55 in number, Prognostic factors found to be significantly related to the outcome in this study.these factors include:young age group (below 12 months) , prolonged seizure at presentation more than 72hours, various CSF parameters (CSF neutrophil predominance pleocytosis, high CSF protein more than 50mg/dl, low CSF glucose below than 40mg/dl, CSF culture positive results), a variety of serum laboratory findings ( positive C-reactive protein more than 12, leukopenia below 4000), and Streptococcus pneumoniae in blood culture is considered important in predicting complications. Conclusion: In conclusion, the age of less than 12 months and the clinical presentation on admission (occurrence of seizures especially prolonged one), as well as multiple CSF and serum laboratory findings were identified as the strongest predictors of neurological complications and may have value predicting which patients are prone to complication.

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