Clinical data and factors associated with poor outcome in pneumococcal meningitis
- 7 December 2005
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Pediatrics
- Vol. 165 (5), 285-289
- https://doi.org/10.1007/s00431-005-0024-9
Abstract
We carried out a 4-year study of 159 children (ages 1 month–14 years) with pneumococcal meningitis. The study was divided into two periods: the retrospective period (1998–2000: 107 patients), and the prospective period (2001–2002: 52 patients). About 2/3 of the children were under 2 years of age: 72 (45%) were under 1 year of age and 38 (24%) had meningitis during the second year of life. One-third of the patients had signs of otitis media; convulsions were more frequent in patients under 1 year compared with older patients (34.7 vs. 14.9%; P=0.004); 13/159 children (8.2%) died; 93/159 (58.5%) recovered completely, 12.6% had motor sequelae, 6.9% hydrocephalus, 29.8% sensorineural hearing loss; 140/159 (88%) were treated with third generation cephalosporins, yet only 8.7% of the pneumococci identified were completely penicillin-resistant (≥1 μg/ml); 119/159 were treated with dexamethasone. Four patients had received an injection of heptavalent vaccine. Antibiotics for 1 week prior to admission, shock, abnormal pupils, leukocytes count 16,000/mm3 died. Conclusion. Sequelae are very common in pneumococcal meningitis. Poor outcome was associated with pupillary abnormality and a leukocyte count 3 on admission. Leukocytosis was protective against poor outcome.Keywords
This publication has 27 references indexed in Scilit:
- The epidemiology of invasive Streptococcus pneumoniae disease in Catalonia (Spain)A hospital-based studyVaccine, 2002
- Recommended Childhood Immunization Schedule—United States, 2002Published by American Academy of Pediatrics (AAP) ,2002
- Streptococcus pneumoniae in children in Spain: 1990–1999Acta Paediatrica, 2000
- Proportion of Invasive Pneumococcal Infections in German Children Preventable by Pneumococcal Conjugate VaccinesClinical Infectious Diseases, 2000
- Worldwide Haemophilus influenzae Type b Disease at the Beginning of the 21st Century: Global Analysis of the Disease Burden 25 Years after the Use of the Polysaccharide Vaccine and a Decade after the Advent of ConjugatesClinical Microbiology Reviews, 2000
- Outcome of meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae type b in children in The GambiaTropical Medicine & International Health, 2000
- Bacterial Meningitis in the United States in 1995New England Journal of Medicine, 1997
- Pneumococcal Meningitis in Children: Prognostic Indicators and OutcomeClinical Infectious Diseases, 1995
- Hearing impairment after bacterial meningitis: a review.Archives of Disease in Childhood, 1992
- Severity of childhood bacterial meningitis and duration of illness before diagnosisThe Lancet, 1991