Partially treated bacterial meningitis among children in Al-Anbar governorate

ABSTRACT

Partially treated bacterial meningitis is an important clinical entity to be aware of particularly in an environment of empirical prescription of antibiotics, as it may delay the child's presentation to hospital and alter the cerebrospinal fluid findings. To find out the effect of partial antibiotic treatment on the clinical presentation and laboratory findings among children with bacterial meningitis in Al-Anbar governorate. The medical records of fifty children with bacterial meningitis that were admitted to Al-Ramadi Maternity and Children hospital during the period 1[st] February 2000 till 31[st] January 2002, were reviewed retrospectively the patients were divided into untreated group and partially treated group. Partial antibiotic treatment in children with bacterial meningitis had no significant effect on the presenting signs and symptoms, cerebrospinal fluid cell count, protein, and glucose, when compared to the untreated group, while cerebrospinal fluid culture showed significant difference between untreated group 24/24 [100%] and partially treated group 11/26 [42.3%]. P<0.05. Among the different available diagnostic tests, cerebrospinal fluid enzyme linked immunosorbent assay had the best yield in both untreated group [90.9%] and the partially treated group [95.8%]. Partial antibiotic treatment in bacterial meningitis among children does not mask the clinical features nor significantly changes the cerebrospinal fluid cell count, protein, glucose, and bacterial antigen detection by immunoassay, however, it has a significant effect on the positive yield of cerebrospinal fluid culture