J Korean Pediatr Soc.  2003 Apr;46(4):345-350.

Prognostic Value of Repeated Cerebrospinal Latex Agglutination Testing in Bacterial Meningitis

• Lee SJ
• Ahn SH
• Cho SJ
• Kim HS
• Lee SJ

Abstract

PURPOSE
Bacterial meningitis is a serious infection of childhood associated with a significant morbidity and mortality. Repeated cerebrospinal fluid(CSF) examination is a useful prognostic indicator and a delayed sterilization is associated with a higher incidence of neurologic abnormalities. In this study we tried to determine the prognostic value of repeated CSF latex agglutination testing.
METHODS
We retrospectively evaluated 19 patients admitted to Ewha Womans University Mokdong Hospital for bacterial meningitis from January 1997 to June 2002. Bacterial meningitis was confirmed by a positive CSF culture and a positive CSF latex agglutination test. Repeated CSF examinations were done at three, seven, 14, 21 and 28 days after antibiotics therapy. Neuroradiologic studies were performed.
RESULTS
The mean age was 10.6 +/- 12.3 months(range; two to 33 months). The male to female ratio was 2.8 : 1. The causative organisms were Haemophilus influenzae type b 57.9%, Group B Streptococcus 21.1%, Streptococcus pneumoniae 15.7% and Escherichia coli 5.3%. Three days after the initiation of antibiotics therapy, repeated CSF latex agglutination tests persisted as positive in nine (47.4%) out of 19 cases, but all CSF cultures became negative. In those cases with negative latex agglutination tests three days after antibiotics therapy, neuroradiologic findings were completely normal. But, in cases with positive latex agglutination tests three days after antibiotics therapy, neuroradiologic abnormalities such as cerebral infarction, encephalomalasia occurred in 44.4%.
CONCLUSION
Repeated CSF latex agglutination testing was valuable as a prognostic factor in bacterial meningitis. Neuroradiologic abnormalities may occur in cases with delayed clearance of CSF latex agglutination tests more often than in cases with negative latex agglutination tests three days after antibiotics therapy.

Keyword

Bacterial meningitis; Repeated CSF latex agglutination testing; Late neurologic sequelae

MeSH Terms

Anti-Bacterial Agents
Cerebral Infarction
Escherichia coli
Female
Haemophilus influenzae type b
Humans
Incidence
Latex Fixation Tests*
Latex*
Male
Meningitis, Bacterial*
Mortality
Retrospective Studies
Sterilization
Streptococcus
Streptococcus pneumoniae
Anti-Bacterial Agents
Latex