Acute bacterial meningitis: Prevalence, clinical profile and outcome

Vollständiger Abstract

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Introduction: Bacterial meningitis involves inflammation of the meninges due to bacterial infection. Despite improved outcomes globally through immunization and intensive care, it remains a significant cause of morbidity and mortality in Indian children due to poor vaccine coverage, antibiotic resistance, and delayed treatment. Understanding its epidemiology and management is essential for better outcomes. Objectives: To study prevalence, clinical profile, lab profile and outcome in acute bacterial meningitis for children aged 1 month to 5 years, with a male: female ratio of 1.6:1. Common symptoms included fever (91.3%), altered sensorium (57.1%), and headache (46.6%). Cerebrospinal fluid (CSF) pleocytosis, hypoglycorrhachia, and elevated protein were seen in 57%, 34.5%, and 41.4% cases respectively. CSF culture positivity was 17.5%, with Streptococcus pneumoniae being the most common organism. Imaging abnormalities included meningeal enhancement and hydrocephalus. At discharge, 32.8% had sequelae. CSF neutrophil % significantly predicted sequelae (p=0.013), while C-reactive protein and erythrocyte sedimentation rate did not. Risk factors included concurrent infections (32.7%), sinusitis, pneumonia, congenital anomalies, and immunodeficiency. Conclusions: Streptococcus pneumoniae was the most common organism. At discharge, 32.8% had sequelae. CSF neutrophil % significantly predicted sequelae. Risk factors included concurrent infections, sinusitis, pneumonia, congenital anomalies, and immunodeficiency.