title: A prospective study of risk factors for neurological complications in childhood bacterial meningitis.
abstract: OBJECTIVE
  To prospectively analyze the prognostic factors for neurological complications of childhood bacterial meningitis.
  
  
  METHODS
  This prospective study enrolled 77 children from 1 month until 16 years of age, treated for bacterial meningitis during the period of January 1, 2009 through December 31, 2010. 16 relevant predictors were chosen to analyze their association with the incidence of neurological complications. p-values < 0.05 were considered statistically significant.
  
  
  RESULTS
  Of the 77 children treated for bacterial meningitis, 33 patients developed neurological complications (43%), and two children died (2.6%). The etiology of bacterial meningitis cases was proven in 57/77 (74%) cases: 32 meningococci, eight pneumococci, six Gram-negative bacilli, five H. influenzae, five staphylococci, and one S. viridans isolates were found. Factors found to be associated with increased risk of development of neurological complications were age < 12 months, altered mental status, seizures prior to admission, initial therapy with two antibiotics, dexamethasone use, presence of focal neurological deficit on admission and increased proteins in cerebrospinal fluid (CSF) (p < 0.05). Initial pleocytosis > 5,000 cells/mm(3), pleocytosis > 5,000 cells/mm(3) after 48 hours, CSF/blood glucose ratio < 0.20, female gender, previous treatment with antibiotics, community-acquired infection, duration of illness > 48 hours, presence of comorbidity, and primary focus of infection were not associated with increased risk for the development of neurological complications.
  
  
  CONCLUSIONS
  Age < 12 months and severity of clinical presentation at admission were identified as the strongest predictors of neurological complications and may be of value in selecting patients for more intensive care and treatment.
authors.affiliation: Infectious Diseases Clinic, University Clinical Center of Kosovo, Medical Faculty, University of Prishtina, Kosovo. sadie_namani@yahoo.com
authors.forename: Sadie
authors.initials: S
authors.lastname: Namani
authors.forename: Zvonko
authors.initials: Z
authors.lastname: Milenković
authors.forename: Bulëza
authors.initials: B
authors.lastname: Koci
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002493:Central Nervous System Diseases / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000382:microbiology; D010343:Patient Admission; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012640:Seizures / Q000209:etiology