[Study of 312 children with meningitis treated at a University Hospital in the South of Brazil].
The aim of this study is to evaluate the clinical and laboratorial aspects, as well as the etiological profile and the evolution characteristics, of the diverse types of severe meningitis treated at a Pediatric Clinic of a public university hospital. From a descriptive and retrospective study, 312 children at the Pediatric Clinic of the Hospital de Clínicas of the Federal University of Paraná were evaluated between January 2003 and January 2007. All of them had a probable diagnosis of meningitis based on clinical signs, and on the cytological and biochemical alterations in the cerebrospinal fluid routine examination. Viral meningitis (VM) was present in 140 children (45%), 58 had bacterial meningitis (BM - 19%) and etiology was undetermined in 114 (36%). In MB, Neisseria meningitidis was the most frequent etiological agent (25 cases). Predominant clinical symptoms were fever, sickness and headache. The cerebrospinal fluid test showed a high number of polymorphonuclear leukocytes, high protein and low glucose level in MB; mononuclear cells were predominant in VM. Neurological complications were more frequent in BM, and convulsion the most common symptom (6/58 patients). Death happened to one case in VM and 3 in BM. Our conclusions were that the classical triad (headache, vomiting and fever) was the most common clinical manifestation, the cytological and biochemical abnormalities were typical, helping in the differentiation of MB from VM, although a good number of cases ended up with no etiological definition and, finally, immediate neurological complications and death were rare.
Antoniuk
Sérgio A
SA
Departamento de Pediatría, Hospital de Clínicas, Universidad Federal del Paraná, Curitiba, Paraná, Brasil. antoniuk@uol.com.br
Zanon França
Marcela
M
Tannous Tahan
Tony
T
Oliveira Rossoni
Andrea M
AM
Dal-Ri Moreira
Suzana
S
Rodrigues Cruz
Cristina
C
Dal-Pra Ducci
Renata
R
Hamdar
Fatima
F
Tieko Frare Kira
Ariane
A
D000293:Adolescent; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008581:Meningitis / Q000209:etiology; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000523:psychology / Q000628:therapy*; D008587:Meningitis, Viral / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D012189:Retrospective Studies