S Sahai1, S Mahadevan, S Srinivasan, R Kanungo. 1. Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry-605 006, India.
Abstract
OBJECTIVE: To identify causative bacteria from cerebrospinal fluid (CSF) of children with meningitis and analyse various clinical and laboratory parameters. METHODS: Over a 20 month period, September 1994 to April 1996, one hundred episodes of acute bacterial meningitis in children aged 1 month-12 years were studied in a tertiary urban hospital in South India. Organisms were isolated from the cerebrospinal fluid (CSF) in 35% of cases. Among infants and children, the two major pathogens were H. influenzae (17%) and S. pneumoniae (12%). RESULTS: The illness at presentation was mild in 13% and severe in 36% of cases. The association of subdural effusion in children with Salmonella Gp B meningitis merits attention. The overall case fatality rate was 25%. S. pneumoniae had a higher case fatality rate than Salmonella Gp B and H. influenzae (50% vs 17% vs 12%). All the three infants below 3 months of age with S. pneumoniae meningitis died. On analysis of selected clinical and laboratory features by discriminant analysis, CSF culture was the significant (P = 0.02) variable in relation to outcome. In pneumococcal meningitis, CSF WBC count was a highly significant variable in relation to outcome (Wilk's Lambda 0.15, F = 24.64, P = 0.0002). CONCLUSION: Prevention of infections due to H. influenzae and S. pneumoniae should be given higher priority.
OBJECTIVE: To identify causative bacteria from cerebrospinal fluid (CSF) of children with meningitis and analyse various clinical and laboratory parameters. METHODS: Over a 20 month period, September 1994 to April 1996, one hundred episodes of acute bacterial meningitis in children aged 1 month-12 years were studied in a tertiary urban hospital in South India. Organisms were isolated from the cerebrospinal fluid (CSF) in 35% of cases. Among infants and children, the two major pathogens were H. influenzae (17%) and S. pneumoniae (12%). RESULTS: The illness at presentation was mild in 13% and severe in 36% of cases. The association of subdural effusion in children with Salmonella Gp B meningitis merits attention. The overall case fatality rate was 25%. S. pneumoniae had a higher case fatality rate than Salmonella Gp B and H. influenzae (50% vs 17% vs 12%). All the three infants below 3 months of age with S. pneumoniae meningitis died. On analysis of selected clinical and laboratory features by discriminant analysis, CSF culture was the significant (P = 0.02) variable in relation to outcome. In pneumococcal meningitis, CSF WBC count was a highly significant variable in relation to outcome (Wilk's Lambda 0.15, F = 24.64, P = 0.0002). CONCLUSION: Prevention of infections due to H. influenzae and S. pneumoniae should be given higher priority.
Authors: S K Kabra; P Kumar; I C Verma; D Mukherjee; B H Chowdhary; S Sengupta; R N Singh; S P Khatua; N Miglani; K M Sehai Journal: Indian J Pediatr Date: 1991 Jul-Aug Impact factor: 1.967
Authors: B K Das; N K Arora; P Mathur; P Ostwal; S Mandal; S K Kabra; A Kapil; M K Lalitha; K Thomas Journal: Indian J Pediatr Date: 2002-09 Impact factor: 1.967
Authors: Syeda Fasiha Mohammadi; Asha B Patil; Shobha D Nadagir; Namrata Nandihal; S A Lakshminarayana Journal: Ann Indian Acad Neurol Date: 2013-10 Impact factor: 1.383
Authors: Donald Waters; Issrah Jawad; Aziez Ahmad; Ivana Lukšić; Harish Nair; Lina Zgaga; Evropi Theodoratou; Igor Rudan; Anita K M Zaidi; Harry Campbell Journal: J Glob Health Date: 2011-12 Impact factor: 4.413