Résumé
Objective: To determine the diagnostic accuracy of pneumococcal antigen detection indiagnosis of pneumococcal meningitis in children. Methods: Purulent meningitis wasdiagnosed according to European Society for Clinical Microbiology and Infectious Diseases(ESCMID) guideline between July 2014 and June 2016. Along with a cerebrospinal fluid(CSF) culture, pneumococcal antigen detection in cerebrospinal fluid (CSF) was performed,and further identification of pathogens was done with 16S rDNA-PCR and high-throughputsequencing. Results: CSF samples collected from 184 children (median age of 1.92 mo).CSF culture was used as the gold standard. 46 (25%) had positive results for culture and 10(5.4%) were pneumococci; 34 (18.5%) were pneumococcal antigen positive. The sensitivityand specificity of pneumococcal antigen detection were 100% (95% CI: 89.4%–100%) and86.2% (95% CI: 96.4%–99.9%), respectively. 92.3% (12/13) were confirmed by nucleic aciddetection to be pneumococci. Conclusions: Pneumococcal antigen detection in CSF hasadequate sensitivity and specificity in diagnosing pneumococcal meningitis.
Résumé
Objective To study the effect of early application of heparinate in fulminant epidemic cerebrospinal meningitis in children.Methods Twenty eight patients of fulminant epidemic cerebrospinal meningitis were reviewed and summarized.Results After application heparinate, there were 14 out of 28 platelet increase,12 patients died of diffuse intravascular coagulation.Conclusion Early application heparination is safe and effective in fulminant epidemic cerebrospinal meningitis,and side effect such as hemorrhage is not found.