Meningitis in the newborn--a 14 year review.

Bell, Angela H.; Brown, Diane; Halliday, Henry L.; McClure, G; McReid, M

doi:10.1136/adc.64.6.873

Cited by 53 publications

(18 citation statements)

References 6 publications

(1 reference statement)

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“…Our results of 97.2% survival at discharge or 94.4% of ultimate survival and 91.1% normality of survivors at follow-up at more than 6 months of age compare very favourably with previous reports [5][6][7][8]18]. There was no difference in terms of mortality and morbidity between the neonates who developed meningitis in the first week of life and those who developed the disease later.…”

Section: Discussionsupporting

confidence: 79%

Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

et al. 2000

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The aim of this retrospective study was to evaluate the clinical efficacy in terms of mortality and long-term morbidity of third generation cephalosporins and amikacin in combination for the treatment of gram-negative bacterial meningitis in a homogeneous group of neonates. A 15-year experience (1983–1997) with 72 term neonates without central nervous system anomalies and with gram-negative organisms grown in their cerebrospinal fluid treated with the above combination of antibiotics is presented. All isolated organisms were sensitive to cefotaxime or ceftazidime and to amikacin but 80% were resistant to ampicillin. The predominant infecting organism was Escherichia coli (68.0%) which was sensitive to both cefotaxime and amikacin in all cases but resistant to ampicillin in 48% of cases. Survival at discharge was 97.2% but ultimate survival was reduced to 94.4%, as 2 patients died a few months following discharge of conditions unrelated to meningitis. Ventriculitis was diagnosed in 10 neonates (13.8%). Among survivors, 1 neonate (1.3%) developed hydrocephalus needing shunting and 1 neonate (1.3%) with Proteus mirabilis developed a brain abscess with relapse of meningitis which was successfully treated with a 6-week course of chloramphenicol. At follow-up at an age greater than 6 months, 91.1% of the surviving infants were normal, while 92.3% of survivors at an age greater than 6 years were normal and attended normal school. These results, despite any reservations due to the nature of the study (retrospective, uncontrolled study), strongly support the use of third generation cephalosporins and amikacin in combination for the treatment of neonatal gram-negative bacterial meningitis.

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Section: Discussionsupporting

confidence: 79%

Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

et al. 2000

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“…Meningitis can be heralded by increasing irritability, alteration in consciousness, poor tone, tremors, lip smacking, or twitching of facial muscles or an extremity. Because cranial sutures in the neonate are open and allow for expansion of the intracranial contents and for increasing head size, a full or bulging fontanelle can be absent [448,477]. Approximately half of the seizures were focal, and at their onset, they usually were subtle.…”

Section: Neurologic Signsmentioning

confidence: 99%

Bacterial Sepsis and Meningitis

Nizet¹,

Klein²

2011

Infectious Diseases of the Fetus and Newborn

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“…In our series, the NPM was complicated by brain abscess in 7.3% of cases, cerebral venous thrombosis in 5.5% of cases and cerebral infarction in 3.6%. Empyema is rare in the NPM [15]. It was noted in one of our patients.…”

Section: Discussionmentioning

confidence: 72%

“…Despite medical advances, the mortality rate of NPM remains high varying between 5 and 78.5% depending on the series [15,[17][18][19]. During the past 3 decades, the case fatality rate decreases in developed countries from 50% in 1970 to less than 10% in 1997 [5,20].…”

Section: Discussionmentioning

confidence: 99%