Prognosis of bacterial meningitis
OBJECTIVES. To review the literature on the risk factors for bacterial meningitis (BM) and evaluate these factors in children diagnosed as having BM in the Paediatric Department of the University Hospital of Maracaibo between 1996 and 1998.
PATIENTS AND METHODS
We made a retrospective study of children diagnosed as having BM in the Univerisity of Maracaibo. We evaluated different factors related to BM.
RESULTS
From 1 January 1996 to 31 December 1998 a total of 152 children were diagnosed as having bacterial meningitis; 69.7% were boys and 30.3% were girls. The commonest causal germ was Haemophilus influenzae. Disorders of sensation (42.7%) and signs of meningism (32.8%) were the most frequent neurological alterations. The main laboratory findings were leucocytosis (51.3%), thrombocytosis (49.3%), pleocytosis (70.3%), cerebrospinal fluid protein (49.3%) and low cerebrospinal fluid glucose (72.8%). Twelve patients (7.5%) died. Of this group, 10 were under one year of age and had septic shock.
CONCLUSIONSBM
represents a major group of hospital admissions in everyday paediatric practice. Although the mortality has decreased, an increased risk of sequelas must be borne in mind. Clinico-neurological examination on admission and simultaneous analysis of laboratory investigations allows identification of prognostic indicators of morbidity and mortality
Pacientes y métodos Estudio retrospectivo de los niños diagnosticados de MB en el Hospital Universitario de Maracaibo. Se valoraron distintos factores relacionados con la MB.
Resultados Desde el 1 de enero de 1996 al 31 de diciembre de 1998 se diagnosticaron un total de 152 niños con meningitis bacteriana, el 69,7% eran niños y el 30,3% niñas. El germen causal más frecuente fue el Haemophilus influenzae. Los trastornos del sensorio (42,7%) y los signos meníngeos (32,8%) fueron las alteraciones neurológicas más frecuentes. Los hallazgos de laboratorio mayormente observados consistieron en leucocitosis (51,3%), trombocitosis (49,3%), pleocitosis (70,3%), proteinorraquia (49,3%) e hipoglucorraquia (72,8%). Doce pacientes (7,5%) fallecieron. De este grupo, 10 eran menores de 1 año y presentaron shock séptico.
Conclusiones La MB representa un grupo importante de admisión hospitalaria en la práctica pediátrica diaria. Si bien la mortalidad ha descendido, hay que tener en cuenta el riesgo aumentado de secuelas. El examen clínico-neurológico al ingreso y el análisis simultáneo de los exámenes de laboratorio permiten identificar los indicadores pronósticos de morbilidad y mortalidad
