Pneumococcal meningitis in Taiwanese children: emphasis on clinical outcomes and prognostic factors.
Pneumococcal meningitis causes high morbidity or mortality in childhood despite the progress in medicine. Children with pneumococcal meningitis were identified and retrospectively reviewed. Forty-nine children were eligible, with mortality in 24.5% of all and neurological sequelae in 40.5% of survivors. In the analysis of clinical profiles, ventilator support (p = 0.001), septic shock (p < 0.001), multiple organ failure (p < 0.001) and lower cerebrospinal fluid (CSF) leukocyte count (p = 0.001) were more frequently found in non-survivors. Besides, CSF protein (p = 0.006) was higher in survivors with neurological sequelae. Initial dexamethasone usage and disease severity did not affect the occurrence of neurological sequelae. Multivariate logistic regression analysis revealed that CSF leukocyte count <or=200 mm(-3) (p = 0.013) and protein level >or=330 g l(-1) (p = 0.022) were significantly risk factors associated with poor outcomes, and physicians should be cautious if such conditions occur.
Tsai
Ming-Han
MH
Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan.
Chen
Shih-Hsiang
SH
Hsu
Chih-Yi
CY
Yan
Dah-Chin
DC
Yen
Meng-Hsiu
MH
Chiu
Cheng-Hsun
CH
Huang
Yhu-Chering
YC
Lin
Tzou-Yien
TY
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D015999:Multivariate Analysis; D009460:Neurologic Examination; D011379:Prognosis; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome