title: Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae.
abstract: OBJECTIVE
  To assess acute neurological complications and neurological sequelae of childhood acute bacterial meningitis in order to determine possible warning signs.
  
  
  METHODS
  This retrospective study evaluated children with acute bacterial meningitis (between 1 month and 14 years of age) admitted between 2003 and 2006.
  
  
  RESULTS
  Of the 44 patients studied, 17 (38.6%) had acute neurological complications. Seizure was the most frequent (31.8%) complication. Patients with acute neurological complications showed a higher frequency of lower neutrophil count (p = 0.03), seizure at admission (p < 0.01), and S. pneumoniae as the etiologic agent (p = 0.01). Risk factors for the development of acute neurological complications were S. pneumoniae (odds ratio [OR] = 6.4, confidence interval [CI] 1.7-24.7) and neutrophil count < 60% (p < 0.01). Of the 35 patients who were followed up, 14 had neurological sequelae (40%). Behavioral change (22.9%) was the most frequent sequela. Seizures at admission (OR = 5.6, CI 1.2-25.9), cerebrospinal fluid protein concentration > 200 mg/dL (p < 0.01), and cerebrospinal fluid glucose concentration/glycemia ratio (p < 0.01) were identified as risk variables for sequelae.
  
  
  CONCLUSIONS
  Neutrophil count < 60%, seizure at admission, and S. pneumoniae as the etiologic agent were identified as warning signs for acute neurological complications, while protein levels, cerebrospinal fluid glucose concentration/glycemia ratio, and seizure at admission were seen as risk factors for neurological sequelae.
authors.affiliation: Departamento de Pediatria, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil. antoniuk@uol.com.br
authors.forename: Sérgio A
authors.initials: SA
authors.lastname: Antoniuk
authors.forename: Fátima
authors.initials: F
authors.lastname: Hamdar
authors.forename: Renata D
authors.initials: RD
authors.lastname: Ducci
authors.forename: Ariane T F
authors.initials: AT
authors.lastname: Kira
authors.forename: Mônica N L
authors.initials: MN
authors.lastname: Cat
authors.forename: Cristina R da
authors.initials: CR
authors.lastname: Cruz
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001526:Behavioral Symptoms / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D005947:Glucose / Q000134:cerebrospinal fluid*; D006801:Humans; D007223:Infant; D008297:Male; D008586:Meningitis, Pneumococcal / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D009504:Neutrophils / Q000473:pathology*; D012307:Risk Factors; D003294:Seizures, Febrile / Q000209:etiology*
chemical_list: D005947:Glucose