PREVALENCE, CLINICAL FEATURES, LABORATORY VALUES AND TREATMENT OUTCOMES OF BACTERIAL MENINGITIS IN CHILDREN ADMITTED TO PEDIATRICS WARD FROM SEPTEMBER 2015 TO AUGUST 2017G.C: A 2 YEARS RETROSPECTIVE STUDY

Abstract

Summary Background: Bacterial Meningitis, which is the inflammation of membranes covering the brain and spinal cord due to bacteria, is one of the most common causes of morbidity and mortality especially among children. The presence of diverse risk factors, nonspecific clinical features, and ever evolving causative microorganisms has contributed to its significance as a public health problem. Thus, studying the aforementioned determinants and presentation can be a significant leap forward in understanding this public health problem. Objective: The objective of this study is to describe the prevalence, clinical features, laboratory values and treatment outcomes of pediatric meningitis. Methods: The source population for this study was patients admitted to SPHMMC pediatrics ward with the diagnosis of bacterial meningitis in the two year period spanning from september 20115 till august 2017G.C. A retrospective quantitative study was conducted. All admitted patients with the diagnosis of meningitis were included in this study. A pretested data collection tool was used to collect data from charts of admitted patients . Data was entered in to SPSS version 20.0 software and analyzed. Results: There were 88 cases of bacterial meningitis identified, of which 53 (60.2%) were males and 35 (39.8%) were females. Majority of the cases (45.5%), were infants followed by those of the age between 1 year and 5 years (29.5%) and the rest (25%) were age above 5 . Their mean age was 1.85 with standard deviation of 0.92 years. The prevalence of bacterial meningitis among patients admitted to pediatrics ward was 4.58%. The most common clinical feature was fever(96.6%) followed by Nausea and Vomiting(76.1%), and seizures(61.4%). The average time at presentation was 4.85 with standard deviation of 5.17 days. Of the 88 cases, risk factors for meningitis, was present in 34.1% of cases. Looking into the details: preceding upper respiratory tract and trauma were present in 17% and 8% respectively. Lack of Vaccination was identified in 9(10.2%) while lack of breast feeding, immunocompromisation and CSF leak were found in single cases. In 40 cases neither a possible risk factor, nor a concomitant source of infection was identified. Over all 7(8%) of cases were bacteriologically confirmed while 81(92%) were presumptively diagnosed. Streptococcus pneumoniae and Nisseria meningitidies were identified in 2(2.2%) cases each. The yield for CSF gram stain, CSF culture and blood culture was 8.1%, 28.5%, and 12.5% respectively. After treatment 54(61.4%) cases achieved complete recovery while death and recovery with sequel were the outcomes in 17(19.3%) cases each. Conclusion: In conclusion, bacterial meningitis is a prevalent disease that is most commonly manifested by fever, vomiting and change in mentation. In this study, it affected infants disproportionately and had a male predominance. It was usually diagnosed clinically and treated emipirically and had high morbidity and mortality.