Bacterial meningitis in infants: the epidemiology, clinical features, and prognostic factors

Chang, Cheng-Jong; Chang, Wen-Neng; Huang, Laura; Huang, Song‐Chei; Chang, Ying-Chao; Hung, Po-Cheng; Lu, Cheng-Hsien; Chang, Chen-Sheng; Cheng, Ben-Chung; Lee, Ping-Yu; Wang, Kuo-Wei; Chang, Hsueh‐Wen

doi:10.1016/s0387-7604(03)00122-0

Cited by 61 publications

(36 citation statements)

References 28 publications

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“…Neisseria meningitidis, considered a rare agent of CNS infection in the neonatal age, was found in 3 cases (8.8%). The predominance of enterobacteria in our patients is supported by other studies 10,11 , which show that these microorganisms are the main etiological agents of bacterial meningitis in the neonatal period in developing countries.…”

Section: Discussionsupporting

confidence: 89%

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Clinical outcome of neonatal bacterial meningitis according to birth weight

Krebs¹,

Costa²

2007

Arq. Neuro-Psiquiatr.

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-Objective: To describe the clinical outcome and the complications of bacterial meningitis according to birth weight of out born neonates admitted in intensive care unit during an 11 year-period. Method: Eighty-seven newborns were studied. Thirty-four infants were low birth weight newborn and 53 presented birth weight ≥2500 g. The clinical data were obtained through the analysis of patients' files. Fisher's exact test, the χ 2 and the Mann-Whitney test were applied. Results: Neurological symptoms were more common in infants weighed ≥2500 g (p<0.05). Complications affected half of the cases in both groups. Complications affected half of the cases in both groups, with an overall mortality rate of 11.5%. Conclusion: The rate of complications was high in both groups, regardless of the birth weight. No association was observed between the occurrence of death and birth weight. Infants with positive CSF culture had a poorer prognosis.KEY WORDS: newborn, neonatal meningitis, central nervous system. Evolução clínica da meningite bacteriana neonatal de acordo com o peso de nascimento RESUMO -Objetivo: Descrever a evolução clínica e as complicações da meningite bacteriana de acordo com o peso de nascimento em recém-nascidos admitidos em unidade de terapia intensiva externa durante o período de 11 anos. Método: Foram estudados 87 neonatos, dos quais 34 foram recém-nascidos de baixo peso e 53 apresentaram peso ≥2500 g. Os dados clínicos foram obtidos por análise dos prontuários médicos. Foram realizados teste exato de Fisher, teste do χ 2 e teste de Mann-Whitney. Resultados: Os sintomas neurológi-cos foram mais comuns em neonatos com peso ≥2500 g (p<0,05 ). As complicações ocorreram na metade dos casos em ambos os grupos, com mortalidade global de 11.5%. Conclusão: A freqüência de complicações foi alta em ambos os grupos, independentemente do peso de nascimento. Não houve associação entre óbito e peso de nascimento. Os neonatos com cultura de líquor positiva apresentaram pior prognóstico.PALAVRAS-CHAVE: recém-nascido, meningite neonatal, sistema nervoso central. SP -Brasil. E-mail: verakrebs@uol.com.br Low birth weight newborns present a 3-fold increased risk of acquiring meningitis when compared to those whose birth weight is ≥2500 g 1 . Among very low birth weight neonates (<1500 g) the risk is a 10 to 17-fold higher [2][3][4] . In addition to the immaturity of the immunological system, these neonates frequently present risk factors for infection related to maternal diseases or neonatal conditions 1,3,5 . Dra. Vera Lúcia Jornada Krebs -Rua Iara 123 / 51 -04542-030 São PauloThe objective of this study was to describe the clinical outcome and the complications of bacterial meningitis according to birth weight of out born neonates admitted in intensive care unit during an 11 year-period. METHODEighty-seven newborns with bacterial meningitis who were admitted to the Neonatal Intensive Care Unit (NICU) of the Instituto da Criança, Hospital das Clínicas, University of São Paulo, from January 1 st , 1994 to December ...

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Section: Discussionsupporting

confidence: 89%

“…Others authors have emphasized the high morbidity of neonatal bacterial meningitis [11][12][13] , regardless of the decrease in the mortality. A surveillance study carried out in 2000 and 2001 revealed a mortality rate of 12.4% for meningitis due to B Streptococcus infection in England and Ireland and of 8% in the USA 13 .…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of neonatal bacterial meningitis according to birth weight

Krebs¹,

Costa²

2007

Arq. Neuro-Psiquiatr.

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“…The predisposing factors were not identified in 70% of patients, which reflects the limited understanding of E. coli infection. 3) In the present case, the predisposing factors were not identified. We assumed that asymptomatic urinary tract infection or gastroenteritis was the probable origin of the E. coli infection, although no extracranial focal infection was identified.…”

Section: Discussioncontrasting

confidence: 52%

“…1,2,11) A large series found that 30 of 80 patients with infantile meningitis had concomitant subdural empyema. 3) The prevalent pathogens of infantile meningitis are Streptococcus species, Haemophilus influenzae, E. coli, and Salmonella species. 3,13) In past large series, E. coli was responsible for 9.7% to 27% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…3) The prevalent pathogens of infantile meningitis are Streptococcus species, Haemophilus influenzae, E. coli, and Salmonella species. 3,13) In past large series, E. coli was responsible for 9.7% to 27% of cases. 3,8,13) Subdural hemorrhage in an infant has been considered to result from rupture of the cortical bridging veins, but recent investigation suggested a dural origin, as the intradural vessels, thin-walled and adapted for fluid resorption, may be the most likely to leak, resulting in bleeding into the dura and simultaneously forming a subdural hematoma either spontaneously or after an otherwise innocuous event.…”

Section: Discussionmentioning

confidence: 99%

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Infantile Chronic Subdural Hematoma Infected by Escherichia Coli -Case Report-

Iimura

Tsutsumi

Mitome

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 6-month-old boy presented with a rare case of infected subdural hemorrhage manifesting as sustained fever and focal seizure. The boy had been well without contributory medical history. Physical examination found no neurological impairment with intact superficial appearance and soft fontanels. The parents denied recent head trauma or shaking injury. Blood examination was normal except for white blood cell count of 19200/ml and C-reactive protein level of 6.7 mg/dl. Bacterial culture of nasal swab, urine, stool, and venous blood samples was negative. Cerebrospinal fluid examination showed normal findings. Cranial computed tomography revealed an expansive subdural fluid collection in the right frontotemporal region. Magnetic resonance imaging showed the lesion as hypointense on T1-and hyperintense on T2-weighted images with intense enhancement of the outer membrane. The patient underwent burr-hole drainage, which identified the subdural hematoma encapsulated in a thick outer membrane and intermingled with pus material. Culture of the pus identified Escherichia coli. The patient received antibiotic therapy for 8 weeks that resulted in complete resolution of the infection. We assumed that preexisting subdural hematoma formed after minor head trauma was followed by hematogenous infection by E. coli. Infected subdural hematoma is possible in infants presenting with subdural hemorrhage with clinical symptoms of bacteremia.

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Epidural Abscess and Subdural Empyema

Hsu

Steinbok

2022

Pediatric Neurosurgery for Clinicians

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Bacterial meningitis in infants: the epidemiology, clinical features, and prognostic factors

Cited by 61 publications

References 28 publications

Clinical outcome of neonatal bacterial meningitis according to birth weight

Clinical outcome of neonatal bacterial meningitis according to birth weight

Infantile Chronic Subdural Hematoma Infected by Escherichia Coli -Case Report-

Epidural Abscess and Subdural Empyema

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