Bacterial meningitis in children

ABSTRACT

To study the demographic features, yield of gram staining, cerebrospinal fluid culture and etiological pattern of bacterial meningitis in children of 2 months to 12 years. Material and A hospital based prospective and descriptive study was carried out at the Department of Pediatrics, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar. All those children in the age group between 2 months to 12 years having clinical suspicion of meningitis and cerebrospinal findings suggestive of meningitis i.e. >10'106 WBC/L and/or CSF sugar <40mg% or [<50% of the circulating blood sugar] and/or CSF protein >80mg% were included in the study. Children having history of intake of antibiotic in the last 5 days which can cross the blood brain barrier and children with tuberculous meningitis were excluded. A total of 120 patients [1.7% of the total admissions] were included in the study. Male patients were 69 [57.5%] and female were 51 [42.5%]. Out of 120, 47[39.2%] were in the age group of 2 months- 1 year, 39 [32.5%] were in the age group of >1-5 years and 34 [26.3%] were in the age group of >5-12 years. Majority of our children were below 5years i.e. 71.7%. Gram staining was positive in 68[56.7%] cases and negative in 52[43.3%]. The CSF cultures were positive in 59[49.2%] cases and negative in 61[50.8%]. The three most common pathogens isolated were Streptococcus Pneumoniae 27[22.5%] cases, Neisseriae Meningitides 20[16.7%] cases and Hemophilus influenzae B 11[9.2%] cases. Bacterial meningitis is the major cause of morbidity in children below the age of 5 years. The yield of gram staining and culture though comparable with the national studies but lower than reported internationally. S Pneumoniae, N Meningitides and H Influenzae are the three most common causes of Bacterial Meningitis in our children as reported nationally and internationally