Etiologies and Outcome of Children with Purulent Meningitis at the Pediatric unit at a Tertiary Medical Centre, West Bengal
Journal Title: Journal of Medical Science And clinical Research - Year 2014, Vol 2, Issue 12
Abstract
Background: Bacterial meningitis is one of the most severe infections in infants and children. It is associated with high mortality and neurological sequelae. In order to improve the prognosis of infants and children with purulent meningitis, we decided to conduct this study whose main objective was to identify the main pathogens responsible and describe the outcome in infants and children aged 2 months to 8 years admitted for purulent meningitis at a tertiary medical centre.. Method: This was a cross-sectional study with retrospective data collection and consecutive sampling. Our study was conducted from 1 January 2007 to 31 December 2013. The patients included in the study were infants and children aged from 2 months to 8 years who were admitted for bacterial meningitis at the BSMCH, Bankura, confirmed by bacteriological examination of cerebrospinal fluid (CSF) with identification of the pathogen by culture. The data was analyzed using SPSS Version 18.0 and Excel 2007. The Chi-square test was used to determine the association of various variables. The significance threshold was set as P < 0.05. Results: We selected 182 cases of purulent meningitis who represented 1.62% of admitted patients. The sex ratio was 1.3. We noted that 45% of our patients were aged 2 months to 1 year. The main presenting complaints were fever, seizures, irritability and vomiting in respectively 97.8%, 50.5% , 41.2% and 39.5% of patients. Streptococcus pneumoniae was found in 72 children (39.56%), followed by Haemophilus influenza in 54 children (29.67%) and Group B Streptococcus in 20 children (10.98%). Acute complications (status epilepticus, coma) were seen in 48.35% of patients. The statistically significant (P < 0.05) factors for poor prognosis were aged from 2 months to 1 year (P < 0.001), GCS Score<8 (P < 0.02), the pathogen (P < 0.001 Pneumococcus), a delay of more than three days between the onset of the disease and the treatment (P < 0.01). We identified 44 deaths (24.1%) and 22 cases (12%) with neurological sequelae before discharge. Conclusion: Streptococcus pneumoniae and Haemophilus influenzae are found to be most common pathogen causing meningitis in our study. Age below one year, pneumococcal infection, delayed treatment > 3 days, the Glasgow coma scale <8 are poor prognostic factor. Wide immunization with pneumococcal conjugate and Haemophilus influenza type-b conjugate vaccines can reduces the incidences of meningitis as well as its outcome
Authors and Affiliations
Dr. Samir Kumar Roy
Keywords
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