title: Central nervous system infection is an important cause of death in underfives hospitalised with World Health Organization (WHO) defined severe and very severe pneumonia.
abstract: Over 6 years, 1667 children aged 2-59 months admitted for pneumonia [1287 severe and 380 very severe] were studied. The case fatality rate (CFR) in children with severe pneumonia was 2.1% and 14.3% with CNS infection, with very severe pneumonia the CFR was 18.9%, 10.4% in those with hypoxemia and 43.6% with CNS infection. High CFRs were associated with CNS infection and inability to drink/cyanosis. The appropriate management of children with very severe pneumonia should include cerebrospinal fluid examination, oxygen monitoring and possibly ventilated support, suggesting that these are minimal standards of care at the district hospital.
authors.affiliation: Research Institute for Tropical Medicine, Philippines.
authors.forename: Socorro P
authors.initials: SP
authors.lastname: Lupisan
authors.forename: Petri
authors.initials: P
authors.lastname: Ruutu
authors.forename: P Erma
authors.initials: PE
authors.lastname: Abucejo-Ladesma
authors.forename: Beatriz P
authors.initials: BP
authors.lastname: Quiambao
authors.forename: Lorena
authors.initials: L
authors.lastname: Gozum
authors.forename: Lydia T
authors.initials: LT
authors.lastname: Sombrero
authors.forename: Vicente
authors.initials: V
authors.lastname: Romano
authors.forename: Ian
authors.initials: I
authors.lastname: Riley
authors.forename: Eric A F
authors.initials: EA
authors.lastname: Simoes
mesh_terms: D000367:Age Factors; D020806:Central Nervous System Bacterial Infections / Q000382:microbiology* / Q000401:mortality*; D002675:Child, Preschool; D006760:Hospitalization; D006801:Humans; D007223:Infant; D011014:Pneumonia / Q000382:microbiology* / Q000401:mortality*; D012720:Severity of Illness Index; D014944:World Health Organization