The impact of a change in referral pathway on a paediatric short-stay ward in Cape Town, South Africa

Finlayson, Heather; Smit, Liezl; Esterhuizen, Tonya; Kruger, Mariana

doi:10.7196/sajch.2016.v10i2.1054

Cited by 1 publication

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“…This most likely reflects the young population which is seen in our casualty and short-stay ward. 13 Some 61% (37/61) of cases with meningitis did not have an HIV status documented, thus the number of HIV infected cases was small and it was, therefore, difficult to draw inferences with regard to the epidemiology of viral meningitis in HIV infected children.…”

Section: Discussionmentioning

confidence: 99%

The impact of cerebrospinal fluid viral analysis on empiric antibiotic use in children admitted to Tygerberg Children’s hospital with suspected meningitis

Kruger

Maritz

Finlayson

2018

Southern African Journal of Infectious Diseases

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Background: Viral meningitis is the most common form of aseptic meningitis and requires minimal investigation and treatment. Polymerase chain reaction (PCR) has become the 'gold standard' for identifying viruses in cerebrospinal fluid and can provide rapid results. The objective of the study was to describe the aetiology and epidemiology of viral meningitis at Tygerberg Children's Hospital, as well as the impact of a positive cerebral spinal fluid (CSF) viral panel on the duration of empiric antibiotic treatment. Methods: This was a retrospective folder review of all children aged between 29 days and 13 years who had a CSF specimen on which a viral analysis was performed from January 1, 2010 to December 31, 2014. Results: A total of 288 specimens were identified from the laboratory database. Seventy-nine specimens were presented for data analysis. Thirty-seven specimens had a positive viral analysis. The median age was 11.3 months (IQR 3.7-49.16 months). The microscopy and chemistry results were similar for the two groups except for the CSF lymphocyte count, which was significantly higher in the group with a positive CSF viral analysis compared to those with a negative CSF viral analysis (median 52 vs. 12 × 106/l, p = 0.005). The most common identified virus was Epstein-Barr virus (EBV) (23%), followed by enterovirus (17%). Children with a positive viral analysis tended to receive antibiotics for longer than those who had negative results (p = 0.223). Conclusion:The addition of CSF viral analysis could be helpful in the management of children with meningitis, but at present appears to have little impact on the length of antibiotic use.

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Section: Discussionmentioning

confidence: 99%