Bacterial meningitis in children

Thirumoorthi, M C

doi:10.1007/bf02753587

Cited by 4 publications

(9 citation statements)

References 33 publications

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“…2,8,10 Unfortunately as seen in present study, signs of meningitis can not be used for making early diagnosis as it is seen in 40.47% patients only. Altered sensorium and convulsion are late features.…”

Section: Discussion;-mentioning

confidence: 60%

“…However most western series quote a culture positivity up to 90%. 8 The reason for low yield in our country are not clear but may include poor quality of culture media and use of antibiotics prior to hospitalization. 3,16 Other quick and sensitive techniques of diagnosis of acute bacterial meningitis need to be urgently explored of great promise is the CSF Latex agglutination test which various authors have confirmed as simple with superior sensitivity and specificity and unaffected by previous antibiotics therapy.…”

Section: Discussion;-mentioning

confidence: 91%

“…Kabra et al reviewing a survey of pyogenic meningitis in major centre in India reported frequency of 0.5% to 2.6% of a hospital admission. 2 The community prevalence in international studies have been quoted between 3/100000 in USA 8 , 16/100000 in UK 9 to 45.8/100000 in Brazil 8 . Though all these number are relatively small, the importance of acute bacterial meningitis is chiefly because of the associated high mortality and serious morbidity.…”

Section: Discussion;-mentioning

confidence: 99%

“…Even in developed countries, in spite of availability of all facilities the case fatality rates of bacterial meningitis in early childhood approaches 10%. 8 The complications rate in acute bacterial meningitis is high in spite of aggressive management. 3,8,13 33.33% of our patient had acute complications, including subdural effusion, cerebral infarct, hydrocephalous, cranial nerve palsies, persistent seizures, hemiparesis.…”

Section: Discussion;-mentioning

confidence: 99%

“…8 The complications rate in acute bacterial meningitis is high in spite of aggressive management. 3,8,13 33.33% of our patient had acute complications, including subdural effusion, cerebral infarct, hydrocephalous, cranial nerve palsies, persistent seizures, hemiparesis. Even more disturbing than mortality were sequelae& disabling handicaps in survivors.…”

Section: Discussion;-mentioning

confidence: 99%

See 4 more Smart Citations

Clinical Profile of Pyogenic Meningitis and Its Outcome in Pediatric Age Group.

Chikhlonde¹,

Raut²,

Dahyalkar³

et al. 2016

IJAR

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Section: Discussion;-mentioning

confidence: 60%

Section: Discussion;-mentioning

confidence: 91%

Section: Discussion;-mentioning

confidence: 99%

Section: Discussion;-mentioning

confidence: 99%

Section: Discussion;-mentioning

confidence: 99%

See 3 more Smart Citations

Clinical Profile of Pyogenic Meningitis and Its Outcome in Pediatric Age Group.

Chikhlonde¹,

Raut²,

Dahyalkar³

et al. 2016

IJAR

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Cerebrospinal Fluid TNF-α, IL-6, and IL-8 in Children With Bacterial Meningitis

Prasad

Kapoor

Srivastava

et al. 2014

Pediatric Neurology

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Randomized Clinical Trial of 20% Mannitol Versus 3% Hypertonic Saline in Children With Raised Intracranial Pressure Due to Acute CNS Infections*

Rameshkumar

Bansal

Singhi

et al. 2020

Pediatric Critical Care Medicine

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Objectives: Mannitol is a commonly used osmotherapy agent in raised intracranial pressure. However, the side effects of mannitol are significant. In traumatic brain injury (adult and pediatric), hypertonic saline (3%) shows varied results in comparison with 20% mannitol. We compared the effect of 3% hypertonic saline versus 20% mannitol (using common dosing strategies) on raised intracranial pressure in pediatric acute CNS infections. Design: Open-label randomized controlled trial. Setting: PICU of a quaternary care academic institute. Patients: Children 1–12 years old, with raised intracranial pressure and modified-Glasgow Coma Scale scores less than or equal to 8, were enrolled. Interventions: Patients were randomly assigned to 20%-mannitol (n = 28), 0.5 gram/kg/dose versus 3%-hypertonic saline (n = 29), 10 mL/kg loading followed by 0.5–1 mL/kg/hr infusion. An intraparenchymal catheter was used to monitor the intracranial pressure. The primary outcome was the proportion of patients achieved target average intracranial pressure less than 20 mm Hg during 72 hours. Secondary outcomes were interventions, morbidity, and mortality. Measurements and Main Results: The proportion of patients with target average intracranial pressure (< 20 mm Hg) was higher in hypertonic saline-group as compared to mannitol-group (79.3% vs 53.6%; adjusted hazard ratio 2.63; 95% CI: 1.23–5.61). Mean (± se) reduction of intracranial pressure (–14.3 ± 1.7 vs –5.4 ± 1.7 mm Hg; p ≤ 0.001) and elevation of cerebral perfusion pressure (15.4 ± 2.4 vs 6 ± 2.4 mm Hg; p = 0.007) from baseline were significant in hypertonic saline-group. Mean (± se) intracranial pressure over 72 hours was lower (14 ± 2 vs 22 ± 2 mm Hg; p = 0.009), and cerebral perfusion pressure was higher (65 ± 2.2 vs 58 ± 2.2; p = 0.032) in hypertonic saline-group. Hypertonic saline-group had higher modified-Glasgow Coma Scale score at 72 hours (median, interquartile range 10; 7–11 vs 7; 3–9; p = 0.003), lower mortality (20.7% vs 35.7%; p = 0.21), shorter duration of mechanical ventilation (5 vs 15 d; p = 0.002), and PICU stay (11 vs 19 d; p = 0.016) and less severe neurodisability at discharge (31% vs 61%; p = 0.049). Conclusions: In pediatric acute CNS infections, 3%-hypertonic saline was associated with a greater reduction of intracranial pressure as compared to 20% mannitol.

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Bacterial meningitis in children

Cited by 4 publications

References 33 publications

Clinical Profile of Pyogenic Meningitis and Its Outcome in Pediatric Age Group.

Clinical Profile of Pyogenic Meningitis and Its Outcome in Pediatric Age Group.

Cerebrospinal Fluid TNF-α, IL-6, and IL-8 in Children With Bacterial Meningitis

Randomized Clinical Trial of 20% Mannitol Versus 3% Hypertonic Saline in Children With Raised Intracranial Pressure Due to Acute CNS Infections*

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