Predictors of Meningitis in Children Presenting With First Febrile Seizures

Batra, Prerna; Gupta, Sushan; Gomber, Sunil; Saha, Abhijeet

doi:10.1016/j.pediatrneurol.2010.07.005

Cited by 36 publications

(32 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5 On the other hand few studies, done by Batra et al India and Kimia et al USA found very low prevalence of meningitis in children with febrile seizures i.e., 2.4% and 2.7% respectively. 6,7 Some studies showed intermediate prevalence 4.7% in a study done by Ghotbi and Shiva et al and 4.5% in study done by Batajoo J et al 2,8 In this study not even a single case of meningitis presented as simple febrile seizure, whereas the prevalence of meningitis in children with atypical febrile seizures was 25.87% which is statistically significant finding (P value = 0.05). Kimia et al found that 0.86% of children who presented as first episode of simple febrile seizure, compared with 4.8% of children who presented as complex febrile seizures had meningitis.…”

Section: Discussionsupporting

confidence: 42%

Predictors of meningitis in children presenting with first episode of febrile seizure

Reddy

Khan

Hegde

2016

Int J Contemp Pediatr

View full text Add to dashboard Cite

INTRODUCTIONFebrile seizure is the most common cause of seizures in infants and toddlers presenting in the pediatric emergency department. Two to five percent of children experience at least one or more episodes of febrile seizures. 1Febrile seizures are classified into simple and complex febrile seizures. Simple febrile seizures are defined as generalized seizures occurring only once in a 24-hour period and lasting less than 15 minutes. Whereas, complex/atypical febrile seizures are described as focal seizures, lasting more than 15 minutes and occurring more than one time in 24 hours.2 Simple febrile seizures are benign and self-limiting. They have better prognosis and carry very low risk for further epilepsy. Probability of acute bacterial meningitis presenting as fever with seizures varies from 0.6 % to 6.7 %. 2 ABSTRACTBackground: Febrile seizure is the most common cause of seizures in infants and toddlers presenting to the paediatric emergency department. Two to five percent of children experience at least one or more episodes of febrile seizures. Simple febrile seizures are benign and self-limiting. They have good prognosis and carry very low risk for epilepsy. Probability of acute bacterial meningitis presenting as fever with seizures varies from 0.6% to 6.7%. The American Academy of Paediatrics (AAP) strongly recommends lumbar puncture (for CSF analysis) in the work up of every child under 18 months of age with a first episode of febrile seizure to rule out acute bacterial meningitis. The objective of this study was to determine the occurrence of meningitis in children who presented with first episode of seizure and fever and also the predictors of meningitis among them. Methods: The records of children admitted to Father Muller Medical College and Hospital between 1 st January 2014 to 31 st December 2015 were reviewed. All children between 6 months to 6 years of age having first episode of convulsions, associated with fever were included in the study and subjected to retrospective analysis of data collected from the case sheets. Results: Our study included 105 children with febrile seizures, 49 children had simple febrile seizures (SFS) and 56 children presented as atypical febrile seizures (AFS). Lumbar puncture was performed in 43 children (15 with SFS and 28 with AFS). The CSF analysis was normal in all the children who presented as simple febrile seizures. There was 25.87% prevalence of meningitis in children with atypical febrile seizures who underwent lumbar puncture. The CSF yield suggestive of bacterial meningitis was as high as 50% in children below 1 year in whom lumbar puncture was done. Conclusions: Children presenting with Atypical/Complex febrile seizures who were treated with antibiotics have more likelihood of having meningitis rather than those presenting with simple febrile seizures.

show abstract

Section: Discussionsupporting

confidence: 42%

Predictors of meningitis in children presenting with first episode of febrile seizure

Reddy

Khan

Hegde

2016

Int J Contemp Pediatr

View full text Add to dashboard Cite

show abstract

“…In Batra and et al study the incidence of meningitis was slightly higher in the age group of 12-18 months (2.9% vs. 2.08%), and all cases of meningitis were reported in girls. 5 According to our study in children whom lumbar puncture was performed and were diagnosed with meningitis 40% had positive cerebrospinal fluid culture and none had positive blood culture. In Teach and Geil study out of 243 children with febrile seizures, lumbar puncture was performed only in 66 patients and all CSF cultures were negative.…”

Section: Resultsmentioning

confidence: 75%

“…In Batra and et al study the prevalence of meningitis was 2.4% in children with first febrile seizures. 5 Batajoo and his colleagues conducted a prospective study in children who presented with first episode of fever and seizure in the age group of 6 months to 5 years. Of the 175 children included, 17% were diagnosed to have meningitis.…”

Section: Resultsmentioning

confidence: 99%

“…5 Most febrile seizures are triggered by fevers from viral upper respiratory infections, ear infections, or roseola. However, meningitis, if bacterial in etiology, can also present with fever and a single, self-limited seizure.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore it is a priority to diagnose or exclude bacterial meningitis. 5 According to AAP guidelines in a child who presents with a febrile seizure, a lumbar puncture should be performed in a child who has obvious meningeal signs and symptoms (such as neck stiffness, Kernig or Brudzinski signs) or other clinical signs that are indicative of meningitis or intracranial infection. Additionally lumbar puncture should be considered in any infant between 6 and 12 months of age who is not up to date with Hib or Streptococcus pneumoniae immunizations, or whose immunization status cannot be determined, especially because symptoms and signs of meningeal irritation can be absent in this age group.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations