spectrum of meningitis in neonates and children

ABSTRACT

The medical records of 203 patients admitted with meningitis during two years were reviewed. According to the criteria of the study, cerebrospinal fluid [CSF] culture confirmed the diagnosis of bacterial meningitis in 74 patients [proved group]. Of the remaining 129 patients, where causative pathogens were not identified, 75 were partially treated bacterial, 52 were viral and 2 were tuberculous meningitis. The majority were Pakistanis and Indians representing 65% and most of them were younger than 5 years. Up to age of 2 months, Klebsiella spp. was the most common organism isolated in the neonatal period [12 cases]. Whereas, above the age of 2 months, Hemophilus influenza type B was the predominant pathogen identified particularly up to age of 2 years [14 cases]. Neisseria meningitidis was next in order [12 cases] especially during Haj. Streptococcus pneumoniae was the third organism in frequency being isolated in 8 cases. CSF culture and latex agglutination test were the most reliable in confirming diagnosis. 20% of Hemophilus influenza isolates were resistant to ampicillin and 7% were resistant to ampicillin and chloramphenicol. The addition of third generation cephalosporins to the antimicrobial therapy results in a better promising outcome with reduced incidence of mortality and neurologic deficits