ABSTRACT
Objective: To determine the disease pattern, etiological agents and outcome of childhood acute bacterial meningitis. Study Design: A descriptive study. Place and Duration of Study: Department of Paediatric Medicine. The Children's Hospital. Lahore, from January to December 2012
Methodology: A total of 199 children between the ages of 1 month and 5 years, admitted with the diagnosis of meningitis on the basis of clinical findings and positive cerebrospinal fluid [CSF], were included. In all patients, complete blood count [CBC], CSF culture sensitivity, and blood culture sensitivity were performed. Data was analysed using SPSS version 20
Results: Out of 199 children. 127 [63.8%] were males with M:F ratio of 1.7:1. Mean age was 11.33 +/-12 months. Maximum numbers of children were < 1 year of age, 136 [68.3%]. Only 90 [45.2%] children were fully vaccinated according to Expanded Program of Immunisation [EPI] schedule. Presentations with refusal to take feed [p=0.008] and with impaired conscious state were independent predictors of death [p=0002]. Complications were noted in 34 [17%] and were significantly associated with severe malnutrition [p=0.006] and altered conscious level at presentation [p<0.001]. The common pathogens identified on CSF culture were coagulase negative staphylococci [CoNS] in 11 [5.5%] and streptococcus pneumoniae in 5 [2 5%]. Overall mortality was 10.1%. The commonest pathogen isolated from children who died was streptococcus pneumoniae [p=0.039]
Conclusion: Acute bacterial meningitis mostly affected children under the age of 1 year. CSF culture revealed both Gram- positive and Gram-negative bacteria. The most common pathogen in children who died was streptococcus pneumoniae