Clinical Characteristics of Pediatric Bacterial Meningitis Complicated with Subdural effusion

Um, Tae Min; Kim, Yong Seok; Yeon, Gyu Min; Nam, Sang Ook; Kim, Young Mi; Lee, Yun Jin

Abstract

PURPOSE
Authors aim to examine the clinical characteristics and relevant factors of the bacterial meningitis with the complication of subdural effusion.
METHODS
We identified the 63 children with bacterial meningitis from 2006 to 2011. Thirteen children (group A) had a complication of subdural effusion during the treatment and 50 children (group B) did not. We reviewed their medical records retrospectively regarding demographic profiles, clinical features and laboratory findings.
RESULTS
The mean age was younger in group A than in group B (4.9+/-10.1 vs 27.2+/-46.5 months, P=0.046). Of the initial symptoms, fever was the most frequent symptom, while seizures (30.8% vs 8.0%, P=0.028) and lethargy (38.5% vs 16.0%, P=0.070) were more common in group A. Since the antibiotics medication, the duration of vomiting (2.5+/-1.5 vs 1.1+/- 0.3 days, P=0.003) and irritability (2.5+/-1.5 vs 1.1+/-0.3 days, P=0.034) was longer in group A. Initial laboratory findings were significantly different between two groups with elevation of CRP (9.4+/-8.6 vs 4.1+/-6.6 mg/dL, P=0.010), CSF neutrophil ratio (71.2+/-16.4 vs 54.1+/-33.4%, P=0.041), and CSF protein (260.2+/-192.5 vs 119.9+/-148.5 mg/dL, P=0.003) in group A. Follow-up examination showed that CRP (9.3+/-10.4 vs 2.7+/-5.5 mg/dL, P=0.011), CSF cell count (670.6+/-1,014.0 vs 123.5+/-243.8 /mm3, P=0.006), and CSF protein (211.5+/-148.3 vs 82.1+/-85.8 mg/dL, P=0.002) were significantly higher in group A.
CONCLUSION
Some significantly different results were shown in the comparison of initial symptoms and their durations and laboratory findings between the patients with subdural effusion following bacterial meningitis and those without subdural effusion.