[Purulent meningitis in childhood. Treatment results in 87 children between 7 month and 15 years of age].
The children were admitted over a 14-year period (1975-1988) from an admission area of average Danish population distribution. The incidence was 15.5/100,000 children per year. The area had endemics of meningococcal disease in the years 1983-1984. The etiology was meningococcal in 43%, Hemophilus influenzae in 33% and pneumococci in 9% of the patients. Regardless of etiology, the antibiotic schedule was ampicillin 400 mg/kg body weight/day. Resistance to ampicillin was not found in any of the bacterial cultures. Within two weeks before admission 59% of the children had experienced a febrile illness. The diagnosis of meningitis was missed before admission in 24% of the cases. On admission, 93% had typical clinical signs of meningitis. 87% were lethargic or comatose. 31% had convulsion and in 13% the peripheral circulation was compromised. Recrudescence was suspected in one patient. Sequelae were most commonly found in children with meningococcal meningitis and were persistent in 23% of all the children. Severe or less severe neurological handicaps were seen in 29% (psychomotor retardation, epilepsy, cerebral palsy and hearing loss). One patient with Waterhouse-Friederichsens syndrome died. Thus the overall mortality was 1.2%, which is low compared to treatment results reported by others.
Madsen
L P
LP
Randers Centralsygehus, paediatrisk afdeling.
Lund
H T
HT
D000293:Adolescent; D000667:Ampicillin / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008583:Meningitis, Haemophilus / Q000188:drug therapy*; D008585:Meningitis, Meningococcal / Q000188:drug therapy*; D008586:Meningitis, Pneumococcal / Q000188:drug therapy*; D012189:Retrospective Studies
D000667:Ampicillin