Clinical Experience with the Diagnosis and Treatment of Suppurative Meningitis in Childrenin 1991-1999

Overview

Between 1991-1999 at the Infectious Diseases Clinic in the Bulovka Hospital 140 children were hospitalized(age 3 months to 15 years) suffering from suppurative meningitis. Neisseria meningitidis was isolated in 51 cases(35 %), Haemophilus influenzae type b in 42 cases (29 %), Streptococcus pneumoniae 13x (9 %). In seven children10 (7 %) other pathogenic organisms were isolated (2x S. aureus, S. epid., S. lentus, L. monocytogenes, S. faecalis,S. salivarius, S. agalactiae, P. aeruginosa, E. coli). In 27 children (20 %) the cultivations were negative, 16 % Hibstrains produced beta-lactamase. Resistance to penicillin was not found in any of the isolated pneumococcal strains.In 7 children (6 %) a malformation or tumour were detected. Seventeen children under the age of 3 years developeda subdural effusion. Six children needed artificial ventilation. Two deaths (1.5 %) were recorded. Nineteen childrendeveloped permanent sequelae, 13 impaired hearing (11 %). The protein and glucose l evels in cerebrospinal fluidwere not significantly correlated with the prognosis of the disease or possible development of sequelae. Dexamet-hasone, administered before the onset of antibiotic therapy did not produce a significant protective effect onhearing nor did it exert a favourable effect on the sequelae in general.

Key words:
suppurative meningitis, hearing, dexamethasone, sequelae