Objective: To investigate the epidemiology of the etiologic agents causing bacterial meningitis in Kuwait. Subjects and Methods: This is a retrospective analysis of the medical records of children 1 month to 12 years old who had cerebrospinal fluid (CSF) findings consistent with meningitis. Patients were identified from the records of the Departments of Microbiology and Communicable Diseases in six regional hospitals during 2001. They were divided into bacterial and viral infective groups. Results: Ninety children had CSF findings consistent with meningitis, 44 bacterial (23 culture proven, 21 probable) and 46 viral. Streptococcus pneumoniae and Neisseria meningitidis were the most frequently isolated organisms (44 and 30%, respectively). A 2-month-old child had Haemophilus influenzae and was the only mortality of this series. S. pneumoniae is the leading bacterial agent causing meningitis in children under the age of 1 year; 61% had bacterial meningitis compared to 37% with viral meningitis. Sequelae were encountered in 23% of bacterial cases. Conclusion: The results indicate that S. pneumoniae is the leading bacterial agent causing meningitis, indicating a need for the introduction of polyvalent pneumococcal vaccine.

Objective: To report an 11-year-old girl with encephalitis-associated pandemic influenza A (H1N1) 2009 virus infection. Clinical Presentation and Intervention: An 11-year-old girl presented with a 6-day history of influenza-like illness followed by an altered mental status for 1 day. She tested positive for pandemic influenza A (H1N1) 2009 virus by PCR of her nasal swab. Her CSF analysis was completely normal, including PCR for pandemic influenza A virus. Her brain MRI and EEG showed evidence suggestive of encephalitis. She was treated with oral Oseltamivir with good recovery. Conclusion: This case report shows that neurological complications can occur after respiratory tract infection with pandemic influenza A (H1N1) 2009 virus.