Abstract
Background and aims: Acute bacterial meningitis is a life-threatening illness with possible long-term neurocognitive sequelae. Aim of the study was to identify clinical and biological factors associated with death or neurological sequelae in a retrospective cohort of children with bacterial meningitis.
Methods: Retrospective cohort study. Inclusion criteria were bacterial meningitis beyond 1 month of age; and death or long-term (>10 yrs) follow-up. Clinical and biological data at admission were retrieved from medical charts.
Results: Eighty-nine patients (age at diagnosis 1 month - 15 years) were enrolled between 1990 and 1999. Nineteen (21%) died, two of them suffered from chronic diseases. At diagnosis, the following variables were associated with survival: absence of seizures (p < 0.05), absence of respiratory distress (p < 0.001), GCS> 12 (p < 0.001), platelets> 150,000/mm3 (p < 0.001), WBC > 5,000 (p< 0.01) and blood neutrophils >1,500 (p< 0.01), no need for mechanical ventilation (p < 0.001). Among children who survived: 42 (60%) did not show any neurocognitive problems; 15 (21.4%) developed hearing loss, 10 (14.2%) mild mental retardation, 8 (11.4%) motor problems, 6 (8.5%) epilepsy, 2 (2.8 %) sleep disorders. None developed psychiatric disorders.
Conclusion: Some factors were significantly associated with survival in children with bacterial meningitis. The overall prognosis was good in more than half of the long-term survivors. The main limit of our study is its retrospective nature. However, since the routine use of vaccines, the incidence of bacterial meningitis has decreased so that prospective studies are difficult to conduct in developed countries.
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D'Agostino, I., Mariani-Kurkdjian, P., Bargui, F. et al. 240 Factors Influencing Neurological Outcome of Children with Bacterial Meningitis. Pediatr Res 68 (Suppl 1), 125 (2010). https://doi.org/10.1203/00006450-201011001-00240
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DOI: https://doi.org/10.1203/00006450-201011001-00240