title: Pneumococcal meningitis in Taiwanese children: emphasis on clinical outcomes and prognostic factors.
abstract: 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.
authors.affiliation: Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Ming-Han
authors.initials: MH
authors.lastname: Tsai
authors.forename: Shih-Hsiang
authors.initials: SH
authors.lastname: Chen
authors.forename: Chih-Yi
authors.initials: CY
authors.lastname: Hsu
authors.forename: Dah-Chin
authors.initials: DC
authors.lastname: Yan
authors.forename: Meng-Hsiu
authors.initials: MH
authors.lastname: Yen
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
authors.forename: Tzou-Yien
authors.initials: TY
authors.lastname: Lin
mesh_terms: 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