Predictors of acute bacterial meningitis among children with a first episode of febrile convulsion from Northern India: A prospective study

Abstract

Context:There is limited data to support need of lumbar puncture among Indian children aged less than 5 years presenting with a first episode of fever and seizure. Aims: To determine the incidence and clinical predictors of meningitis among children aged 6-60 months presenting with a first episode of febrile convulsion. Settings and Designs: A prospective study was conducted on 35 children (6-60 months) with a first episode of febrile convulsion subjected to lumbar puncture in a tertiary care teaching hospital of North India. Materials and Methods: Clinical characteristics were compared between the two groups: Children with meningitis (n = 17) and children without meningitis (n = 18). Statistical Methods: Multivariate logistic regression was applied to assess the independent predictors of meningitis. Results: A total of 120 children were screened; 35 children subjected to lumbar puncture were finally enrolled. The mean (SD) age of enrolled children was 18.49 (10.79) months. The incidence of meningitis was 48.6% (17/35). Children with meningitis significantly had a higher proportion of children with high grade (temperature >104°F) fever (P = 0.005), received prior antibiotics (P = 0. 041), had lower hemoglobin levels (P = 0.04) and lower blood sugar levels (P = 0.03) as compared to children with no meningitis. On multivariate logistic regression, it was observed that high-grade fever was an independent predictor of meningitis (odds ratio: 0.03 [0.001-0.86] [P = 0.04]). Conclusion: We found that the presence of high-grade fever was an important predictor of meningitis among children aged 6-60 months presenting with a first episode of febrile convulsion.

Positivity of Lumbar Puncture for Acute Bacterial Meningitis among Children Presenting with First Febrile Seizure

“…15 The prevalence of meningitis as determined by lumbar puncture was 61.1 percent in the current study, compared to 48.57 per cent in a previous study by Amiraj S et al on Predictors of acute bacterial meningitis among children from Northern India who had experienced their first episode of febrile convulsion. 16 Children with seizures and fever had a 4.7 percent rate of meningitis, according to Ghotbi and Shiva. 17 A study was conducted in America, where the case fatality rate was 32%.…”