J Korean Child Neurol Soc.  2013 Dec;21(4):241-249.

A Clinical Study of Pediatric Bacterial Meningitis in Daejeon and Chungcheong area : 2006-2010

• Park YJ
• Chu CC
• Kim JS
• Kim SS
• Kim YC
• Kim WS
• Yu J
• Lee KS
• Lee YH
• Park HJ

Abstract

PURPOSE
The aim of this study was to investigate the causative organisms, clinical manifestations, and prognosis of pediatric patients with bacterial meningitis in Daejeon and Chungcheong area, occurred from 2006 to 2010.
METHODS
We retrospectively reviewed medical records of patients aged between 1 month and 15 years, diagnosed with bacterial meningitis at 8 university or general hospitals in Daejeon and Chungcheong area. The bacterial meningitis was defined by isolation of organism from cerebrospinal fluid(CSF). The data was collected from January 2006 to December 2010, and analyzed including patient's demographics, causative organisms, clinical presentation, laboratory findings and complications.
RESULTS
During the 5-year study period, 24 patients were diagnosed with CSF culture-proven bacterial meningitis. The most common causative organism was Streptococcus pneumoniae (S. pneumoniae, 37.5%), and the others were group B streptococcus (GBS, 20.8%), Escherichia coli (E. coli, 16.7%), Neisseria meningitidis (N. meningitidis, 8.3%), Haemophilus influenzae (H. influenzae, 4.2%), respectively. They initially complained of fever (95.8%), vomiting (83.3%), anorexia (45.8%), seizure (29.2%), headache (20.8%). The leukocyte counts exceeding 1,000/mm3 in CSF was observed in 14 patients (58.3%). In 15 patients (62.5%), the glucose concentration in CSF was less than 50 mg/dL, 18 patients showed that the protein concentration in CSF was more than 100 mg/dL. Long-term neurologic sequelae were observed in 4 patients (16.7%) and described as hearing disturbance (2 patients), hemiparesis (1 patient) and endocrine dysfunction (1 patient). Ten patients (41.7%) showed abnormal neuroradiologic findings and the most common abnormalities was subdural effusion (25.0%).
CONCLUSION
Compared to the previous study performed between 2001 and 2005, S. pneumonia continued to be the leading cause of the pediatric bacterial meningitis in Daejeon and Chungcheong area. The frequency of pneumococcal meningitis was not decreased, despite of the introduction of conjugated pneumococcal vaccination. On the other hand, H. influenzae meningitis was notably decreased.

Keyword

Bacterial meningitis; Pediatric; Organisms; Streptococcus pneumoniae; Haemophilus influenzae

MeSH Terms

Anorexia
Demography
Escherichia coli
Fever
Glucose
Haemophilus influenzae
Hand
Headache
Hearing
Hospitals, General
Humans
Influenza, Human
Leukocyte Count
Medical Records
Meningitis
Meningitis, Bacterial*
Meningitis, Pneumococcal
Neisseria meningitidis
Paresis
Pneumonia
Prognosis
Retrospective Studies
Seizures
Streptococcus
Streptococcus pneumoniae
Subdural Effusion
Vaccination
Vomiting
Glucose