title: [Clinical analysis of purulent meningitis in 317 children].
abstract: OBJECTIVE
  To study the clinical features, treatment, and prognosis of purulent meningitis (PM) in children.
  
  
  METHODS
  A retrospective analysis was performed on the clinical data of 317 children with PM aged from 1 month to 15 years.
  
  
  RESULTS
  PM was commonly seen in infants (198 cases, 62.6%). Most children with PM had preceding respiratory infection (171 cases, 53.9%). The major clinical manifestations of PM were fever, convulsions, and intracranial hypertension, and convulsions were more commonly seen in infants (152 cases, 93.6%). The major complication was subdural effusion (95 cases, 29.9%). Of the 95 cases of subdural effusion, 22 cases were diagnosed by subdural puncture; 68 cases underwent subdural puncture and 62 cases restored to normal temperature 3-5 days after puncture. Risk factors associated with complications and sequelae were young age and protein≥1 g/L in cerebrospinal fluid (CSF) (OR=0.518, 1.524 respectively; P<0.05). The third-generation cephalosporins were the first choice for PM, and vancomycin or carbapenems were replacement therapy. Thirteen (14.4%) out of 90 children had delayed cerebral vasculitis during a follow-up visit within 3 months after discharge.
  
  
  CONCLUSIONS
  PM is more commonly seen in infants, and the infants have a high incidence of convulsions. Young age and protein≥1 g/L in CSF may increase the risk of complications and sequelae. Subdural puncture is not only a diagnostic method but also a therapy for subdural effusion. Some children have delayed cerebral vasculitis during a follow-up visit within 3 months after discharge, so follow-up visits should be performed within 3 months after discharge.
authors.affiliation: Department of Internal Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400016, China. joylm99@126.com.
authors.forename: Qing-Qing
authors.initials: QQ
authors.lastname: Xu
authors.forename: Mei
authors.initials: M
authors.lastname: Li
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D013492:Suppuration / Q000382:microbiology