Clinical analysis on 430 cases of infantile purulent meningitis

Abstract

BackgroundPurulent meningitis (PM) usually caused by a variety of pyogenic infection, is a kind of central nervous system infectious disease mostly common in children. It is easily misdiagnosed and its symptoms are varied. Excessive application of broad-spectrum antibiotics results in increased sickness and death of infants and young children. In this study, clinical data of 430 cases of PM in infants were analyzed to summarize the clinical experiences so as to achieve early diagnosis and early treatment of PM.ResultsMale-to-female ratio was 1.61:1, and the median age of incidence was 0.42 years. May was the modal month of onset (11.7%). Main clinical manifestations were fever (89.3%), vomiting (67.2%), mental fatigue (62.1%), anterior fontanelle full/bulging/high tension (54.2%), convulsion (52.6%), and meningeal irritation sign (24.7%). Cerebrospinal fluid (CSF) bacterial culture was done for 420 cases, of which 1.2% cases were positive. Blood culture was done for 146 cases of which 15.1% were positive. 175 (40.7%) cases had complications, among which 133 cases (76.0%) were subdural effusion, 21 cases (12.0%) were epilepsy.ConclusionInfantile PM is common in Spring, and May is the modal month of onset. The CSF/blood pathogen detection rate is very low and it is difficult to find evidence of cause. Fever, vomiting, mental fatigue and anterior fontanelle full/bulging/high tension, convulsion are the main clinical manifestations on which diagnosis depends. For those children diagnosed as PM and still having recurrent fever and prominent anterior fontanelle after treatment, clinicians should consider the probability of subdural effusion and treat them with brain imaging test on time.

Simultaneous Detection of Bacterial Meningitis in Suspected Cases of Meningitis in Children Using PCR Assay, In Taif, Saudi Arabia

“…The positive results were detected in 0.3% of CSF specimens. This results is much lower than in previously reported data [3,18,25,26]. This failure to isolate bacteria by CSF culture and the risk of false negative result were high because either only a small number of microorganisms may be present in the specimens or the low quality of CSF samples and the use of antibiotics prior to the lumbar puncture.…”

“…The usual signs and symptoms do not provide optimal sensitivity and specificity for distinguishing possible BM from viral meningitis. In addition, more and more unreasonable and irregular applications of antibiotics have increased the atypical features of BM, which made it difficult to seek pathogenic evidence [25].…”

Clinical manifestations and laboratory results of 61 children with infectious mononucleosis

“…This finding was consistent with some recent domestic reports. [10][11][12] Fever, herpangina, and lymphadenopathy were the most common clinical manifestations in children with IM, followed by hepatosplenomegaly and eyelid edema. These findings were also consistent with those of domestic reports.…”

Reappraisal of the Optimal Dose of Meropenem in Critically Ill Infants and Children: a Developmental Pharmacokinetic-Pharmacodynamic Analysis

“…We conducted a multicenter prospective, open-label PK-PD study of meropenem in Beijing Children's Hospital, Baoding Children's Hospital, and Guizhou Provincial People's Hospital. Patients admitted to pediatric intensive care unit were included if they (i) were aged from 1 month to 15 years; (ii) met the criteria for bacterial meningitis (21), sepsis (7), or severe pneumonia (22), and (iii) had received meropenem as part of empirical or definitive therapy for Ͼ48 h. Patients who were enrolled in another clinical trial and had received metronidazole or who were hypersusceptible to carbapenems were excluded. The study protocol was approved by the Ethics Committee of each participating hospital (2019-k-185) and is registered on clinicalTrials.gov (ClinicalTrials registration no.…”