Clinical and laboratorial characteristics of bacterial meningitis in children

Lucena, Rita; Gomes, Irênio; Ferreira, Adriana; Góes, Julieta; Araújo, Ismara; Veiga, Marielza; Melo, Ailton

doi:10.1590/S0004-282X1996000400004

Abstracts

Data from the records of 528 children under 15 years old with diagnosis of acute bacterial meningitis, admitted at the Hospital Couto Maia between 1990 and 1992 were analyzed. Bacterial meningitis was more frequent in children under the age of 1 year (37.8%). The most common etiologic agent was H. influenzae (42.2%). The global letality was 20.9%. Individual predictors of poor outcome were: absence of the "classic triad", CSF cell count under 1000 /mm³, age under 2 years, presence of seizures, depressed sensorium, and S. pneumoniae as causal agent.

bacterial meningitis; children; clinical and laboratory findings; prognosis

Foram analisados dados de prontuário de 528 crianças com faixa etária entre 1 mês e 15 anos e diagnóstico de meningite bacteriana aguda, admitidas no Hospital Couto Maia entre 1990 e 1992. Meningite bacteriana foi mais frequente em crianças com idade inferior a 1 ano (37,8%). O agente etiológico mais comum foi H. influenzae (42,2%). A letalidade global foi 20,9% e os fatores preditivos de pior prognóstico foram: ausência da "tríade clássica" (febre, vômitos e rigidez de nuca), celularidade do líquido cefalorraquidiano inferior a 1000 /mm³, idade inferior a 2 anos, presença de convulsões, alteração do nível de consciência e S. pneumoniae como agente causal.

meningite bacteriana; crianças; características clínicas e laboratoriais; prognóstico

Características clínicas e laboratoriais de meningites bacterianas em crianças

Clinical and laboratorial characteristics of bacterial meningitis in children

Rita Lucena^I; Irênio Gomes^II; Adriana Ferreira^III; Julieta Góes^III; Ismara Araújo^III; Marielza Veiga^II; Ailton Melo^IV

^IServiço de Neurologia, Universidade Federal da Bahia (UFBA): Médica

^IIServiço de Neurologia, Universidade Federal da Bahia (UFBA): Docente

^IIIServiço de Neurologia, Universidade Federal da Bahia (UFBA): Estagiária

^IVServiço de Neurologia, Universidade Federal da Bahia (UFBA): Chefe de Serviço

RESUMO

Foram analisados dados de prontuário de 528 crianças com faixa etária entre 1 mês e 15 anos e diagnóstico de meningite bacteriana aguda, admitidas no Hospital Couto Maia entre 1990 e 1992. Meningite bacteriana foi mais frequente em crianças com idade inferior a 1 ano (37,8%). O agente etiológico mais comum foi H. influenzae (42,2%). A letalidade global foi 20,9% e os fatores preditivos de pior prognóstico foram: ausência da "tríade clássica" (febre, vômitos e rigidez de nuca), celularidade do líquido cefalorraquidiano inferior a 1000 /mm³, idade inferior a 2 anos, presença de convulsões, alteração do nível de consciência e S. pneumoniae como agente causal.

Palavras-chave: meningite bacteriana, crianças, características clínicas e laboratoriais, prognóstico.

ABSTRACT

Data from the records of 528 children under 15 years old with diagnosis of acute bacterial meningitis, admitted at the Hospital Couto Maia between 1990 and 1992 were analyzed. Bacterial meningitis was more frequent in children under the age of 1 year (37.8%). The most common etiologic agent was H. influenzae (42.2%). The global letality was 20.9%. Individual predictors of poor outcome were: absence of the "classic triad", CSF cell count under 1000 /mm³, age under 2 years, presence of seizures, depressed sensorium, and S. pneumoniae as causal agent.

Key words: bacterial meningitis, children, clinical and laboratory findings, prognosis.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 29-julho-1996.

Dr. Ailton Melo - Alameda das Espatódias 509, Caminho das Árvores - 41820-460 Salvador BA - Brasil.

1. Baraff LI, Lee SI, Schriger DL. Outcomes of bacterial meningitis in children: a meta-analysis. Pediatr Infect Dis J 1993;12:389-394.
2. Blazer S, Berant M, Alon U. Bacterial meningitis: effect of antibiotic treatment on cerebrospinal fluid. Am J Clin Pathol 1993;80:386-387.
3. Bryan JP, Silva HR, Tavares A, Rocha H, Scheld WM. Etiology and mortality of bacterial meningitis in Northeastern Brazil. Rev Infect Dis 1990;12:128-135.
4. Cadoz M, Denis F, Diop Mar I. Etude épidemiologique des cas de méningites purulentes à Dakar pendant la décennie 1970-79. Bull Org Mond Santé 1981;59:575-594.
5. Durand ML, Calderwood SB, Weber DJ, Swartz MN. Acute bacterial meningitis in adults: a rewiew of 493 episodes. N Engl J Med 1993;328:21-28.
6. Fahrat CK, Mantese OC. Meningites bacterianas purulentas. In Tonelli E. Doenças infecciosas na infância. Rio de Janeiro: MEDSI, 1987:365.
7. Feigin RD. Bacterial meningitis beyond the neonatal period. In Feigin RD, Cherry JD. Textbook of pediatric infectious diseases.Philadelphia: Saunders, 1987:831-863.
8. Gomes I, Melo A, Lucena R, Cunha-Nasimento MH, Ferreira A, Góes J, Barreto I, Jones N, Gaspari V, Embiruçu EK, Veiga M. Prognosis of bacterial meningitis in children. Arq Neupsiquiatr 1996;54:407-411.
9. Greenwood BM. Selective primary health care strategies for control of diseases in the developing world: XIII. Acute bacterial meningitis. Rev Infect Dis 1984;6:374-381.
10. Juliet C, Rodriquez G, Marti A, Burgos OV. Meningitis bacteriana en el niño: experiência con 441 casos. Rev Med Child 1983;111:690-696.
11. Klein JO, Feigin RD, McCracken GH. Report of the task force on diagnosis and management of meningitis. Pediatrics 1986;78(Suppl):952.
12. Marton KI, Gean AD. The spinal tap: a new look at an old test. Ann Intern Med 1986;104:840-848.
13. Spanos A, Harrell FE, Durack DT. Differential diagnosis of acute meningitis: an analysis of the predictive value of initial observations. JAMA 1989;262:2700-2707.
14. Wenger JD, Hightower AW, Facklam RR. The Bacterial Meningitis Study Group. Bacterial meningitis in the United States, 1986: report of a multistate surveillance study. J Infect Dis 1990;162:1316-1326.
15. Wispelwey B, Tunkel AR, Scheld WM. Bacterial meningitis in adults. Infect Dis Clin North Am 1990;4:645-659.

Publication Dates

Publication in this collection
12 Nov 2010
Date of issue
Dec 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Baraff LI, Lee SI, Schriger DL. Outcomes of bacterial meningitis in children: a meta-analysis. Pediatr Infect Dis J 1993;12:389-394.

[2] 2. Blazer S, Berant M, Alon U. Bacterial meningitis: effect of antibiotic treatment on cerebrospinal fluid. Am J Clin Pathol 1993;80:386-387.

[3] 3. Bryan JP, Silva HR, Tavares A, Rocha H, Scheld WM. Etiology and mortality of bacterial meningitis in Northeastern Brazil. Rev Infect Dis 1990;12:128-135.

[4] 4. Cadoz M, Denis F, Diop Mar I. Etude épidemiologique des cas de méningites purulentes à Dakar pendant la décennie 1970-79. Bull Org Mond Santé 1981;59:575-594.

[5] 5. Durand ML, Calderwood SB, Weber DJ, Swartz MN. Acute bacterial meningitis in adults: a rewiew of 493 episodes. N Engl J Med 1993;328:21-28.

[6] 6. Fahrat CK, Mantese OC. Meningites bacterianas purulentas. In Tonelli E. Doenças infecciosas na infância. Rio de Janeiro: MEDSI, 1987:365.

[7] 7. Feigin RD. Bacterial meningitis beyond the neonatal period. In Feigin RD, Cherry JD. Textbook of pediatric infectious diseases.Philadelphia: Saunders, 1987:831-863.

[8] 8. Gomes I, Melo A, Lucena R, Cunha-Nasimento MH, Ferreira A, Góes J, Barreto I, Jones N, Gaspari V, Embiruçu EK, Veiga M. Prognosis of bacterial meningitis in children. Arq Neupsiquiatr 1996;54:407-411.

[9] 9. Greenwood BM. Selective primary health care strategies for control of diseases in the developing world: XIII. Acute bacterial meningitis. Rev Infect Dis 1984;6:374-381.

[10] 10. Juliet C, Rodriquez G, Marti A, Burgos OV. Meningitis bacteriana en el niño: experiência con 441 casos. Rev Med Child 1983;111:690-696.

[11] 11. Klein JO, Feigin RD, McCracken GH. Report of the task force on diagnosis and management of meningitis. Pediatrics 1986;78(Suppl):952.

[12] 12. Marton KI, Gean AD. The spinal tap: a new look at an old test. Ann Intern Med 1986;104:840-848.

[13] 13. Spanos A, Harrell FE, Durack DT. Differential diagnosis of acute meningitis: an analysis of the predictive value of initial observations. JAMA 1989;262:2700-2707.

[14] 14. Wenger JD, Hightower AW, Facklam RR. The Bacterial Meningitis Study Group. Bacterial meningitis in the United States, 1986: report of a multistate surveillance study. J Infect Dis 1990;162:1316-1326.

[15] 15. Wispelwey B, Tunkel AR, Scheld WM. Bacterial meningitis in adults. Infect Dis Clin North Am 1990;4:645-659.