A Clinical Observation on Meningitis in Infancy and Chilhdood

ABSTRACT

A clinical observation and comparision was carried out on 466 cases of meningitis in infancy and childhood : 135 cases of purulent meningitis ; 208 cases of aseptic meningitis, and 123 cases of tuberculous meningitis. They were admitted to Jeonju Presbyterian Medical Center from January, 1973 to December, 1979. The results were as follows; 1) Male to female ratio was 2.1:1 in purulent meningitis, 3.2:1 in aseptic meningitis, and 2.4:1 in tuberculous meningitis. 2) The seasonal peak incidence was Spring and Summer for purulent and tuberculous menigitis and Summer for aseptic meningitis. 3) The most predilectional age which resulted in meningitis was infancy in purulent meningitis, 4 to 12 years o fage in aseptic meningitis and 1 to 4 years of age in tuberculous meningitis. 4) Fever was the most frequent symptom ; and vomiting, convulsion, unconsciousness, and headache followed in that order in the three kinds of meningitis. The most frequent neurologic finding was stiff neck; and Kernig's sign, Brudzinski's sign, and Babinski's sign followed in that order in the three kinds of meningitis. 5) In CSF examination on admission, cell counts were most frequently under 1,000/mm3 in purulent meningitis(49.6%), under 50/mm3 in aseptic menigitis (35.6%) and 100 to 300/mm3 in tuberculous meningitis (52.0%). The sugar level in 74.1% of purulent meningitis and in 84.5% of tuberculous meningitis was under 50mg/dl. In aseptic meningitis the sugar level was over 50mg/dl in 72.6%. The protein level was most frequently 30 to 150mg/dl in all three kinds of meningitis. 6) The mortality rate was 14.1% in purulent meningitis, 0.5% in asepic meningitis and 10.6% in tuberculous meningits. 7) The younger the patient in purulent and tuberculous meningitis, the worse the prognosis. The mortality rate of tuberculous meningitis was 9.1% in stage II and 50% in stage III.