A Clinical Observation on Meningitis in Infancy and Childhood

Moon, D K; Kim, S H; Paik, I K; Kang, C M

Abstract

A clinical study of 320 cases of meningitis(purulent 124 cases, tuberculous 94 cases, aseptic 102 cases) in infancy and childhood, which were admitted to the pediatric Department of Keimyung University Medical College and Hospital during the period of 5 years and 6 months from January 1975 through June 1981 was made. The results were summarized as follows: 1. In age distribution, the peak incidence of tuberculous meningitis was during 1~5 years of age, and aseptic meningitis was 5~10 years of age. In purulent meingitis, there was no age predilection. 2. Male was predominant in all meningitis, and male to female ratio was 1.5:1. 3. In seasonal incidence, the prevalence was in March, July and septemper for tuberculous meningitis, January to April and October for purulent meningitis, and December, June and July for aseptic meningitis. 4. The cardinal symptoms on admission were vomiting, fever and headache. In tuberculous and aseptic meningitis, vomiting was the principle symptom, and the fever was for purulent meningitis. 5. The principle signs of physical examinationon on admission were neck stiffness, Kernig's sign and unconciousness in order. In aseptic meningitis, 30.4% of cases have no meningeal irritation signs. 6. In CSF examination, cell counts were over 500/mm3 in 50% of purulent meningitis, but in tuberculous and aseptic meningitis, most frequently in 50~200/mm3 in 50% of purulent meningitis, but in tuberculous and aseptic meningitis, most frequently in 50~200/mm3. Protein levels showed over 100mg% in 67.1% of tuberculous, 65.2%, of purulent meningitis, and 84.8% of aseptic meningitic have under 100mg%. Sugar levels were decreased in 82.3% of tuberculous and 58.6% of purulent meningitis, but in 26.7% of purulent meningitis, sugar level fell below 100mg%. 83.6% of aseptic meningitis showed normal sugar level. 7. Etiologic organisms were isolated from CSF in 16.1% of purulent meningitis. Pneumococci were the most prevalent. 8. Mortality rate was 7.8%(tuberculous 11.7%, purulent, 10.5%, aseptic 1.0%). In 9.7% of cases, sequelae was noted(tuberculous 18.1%, purulent 10.5, aseptic 1.0%).