[Management strategy for pediatric presumptive bacterial meningitis (diagnosis, surveillance, follow-up)].
The epidemiology of bacterial meningitis has changed since the last French consensus in 1996, mainly because of more frequent Haemophilus influenzae B and pneumoccocus vaccination. A research PubMed and Cochrane databases was performed for articles published within the past 12 years, mentioning the diagnosis, surveillance, and follow-up of presumed bacterial meningitis in children. Sixty-one references were included among the 1606 on PubMed and 50 on the Cochrane databases. Additional articles (n=35) were identified using the references of selected articles. The definition of bacterial meningitis was reviewed, particularly when the causal agent was not identified. Clinical and biological criteria for the diagnosis and the place of brain imaging were updated. Guidelines available after the common use of Haemophilus influenzae vaccination were analyzed with their level of evidence. Initial surveillance data and risk factors associated with death or poor outcome were reviewed. The short and long-term follow-up was also analyzed to identify the proper follow-up for children.
Dubos
F
F
Inserm U149, service de pédiatrie générale, urgences et maladies infectieuses, pôle enfant et pôle de l'urgence, CHRU de Lille, 59037 Lille, France. f-dubos@chru-lille.fr
D000208:Acute Disease; D001428:Bacterial Vaccines / Q000627:therapeutic use; D001921:Brain / Q000382:microbiology / Q000473:pathology; D002648:Child; D005500:Follow-Up Studies; D019741:Haemophilus influenzae type b; D006801:Humans; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008583:Meningitis, Haemophilus / Q000175:diagnosis / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012307:Risk Factors; D016019:Survival Analysis
D001428:Bacterial Vaccines