Acute pyogenic meningitis in childhood: a 17-year experience in Bahrain

ABSTRACT

The aetiologic, epidemiologic and clinical aspects of 452 cases of acute pyogenic meningitis in children treated over a 17-year period, from January 1970 through December 1986, were reviewed. An aetiologic agent was identified in 237 cases [52.4%]. H influenzae b was the commonest organism isolated in the culture-positive cases. Ninety per cent [90%] of influenzal, 66% of pneumococcal and 42% of meningococcal meningitis cases were under 2 years of age. About 60% of influenzal and pneumococcal meningitis cases occurred during October through February. A male female ratio of 21 in pneumococcal meningitis was consistently seen throughout the entire period of study. Gross neurological handicaps in 15% of H influenzae b and 14% pneumococcal meningitis were noted. Thirty per cent [30%] of the culture-proven and 59% of the culture-negative cases had received prior antibiotic treatment. Twenty-eight per cent [28%] of the cases presented with seizures and 85% of these were aged 1 year or less. Overall mortality was 9% with a marked reduction in mortality in culture-proven meningitis during the last 7 years of the study. Ampicillin-resistant H influenzae b was isolated from 3 cases, 2 of whom died