[ purulent meningitis of child aged over two years old. Study about 33 observations]

ABSTRACT

The bacterian meningitis is an affection which is more frequent and grave in our country. We reported a retrospective study of 33 cases of purulent meningitis in infants aged between 2 and 14 years. This study had been collected in pediatric department of UHC Hedi Chaker of Sfax during a period of 9 years [1996-2004]. The average age was 6 years with a sex ratio of 1,35. The clinical syndrome was dominated by fever and neurologic signs. The neck stiffness and the Brudzinski sign had been respectively noted in84,8 and 60,6% of cases. The lumbar puncture realized in all infants took of suspicious liquid in 28 cases, clearly in 2 cases and haemorrhagic in 3 cases. The pleiocytosis had been higher in the all cases, il was of neutrophile polynuclear predominance in 84% of cases. A germ had been identified in 14 cases [pneumocoque 6 cases, haemophilus predominance in 84% of cases. A germ had been identified in 14 cases [penumocoque 6 cases, haemophilus 5 cases, meningocoque 2 cases and Klebsiella pneumoniae 1 case. The first intention antibiotherapy was mainly cefotaxim [19 cases], ampicillin [9 cases] or cefotaxim and vancomycin [3 cases]. The initial evolution was favourable in 60% of cases. The neurological and extra neurological complications had been noted in 39% of cases. An infant is dead in a grave septicaemia. The later evolution was favourable in 81,8% of cases definitive after effects had noted in 5 infants [deafness = 4 cases and ataxia = 1 cas]