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Avaliação neurológica e do líquido cefalorraqueano em crianças com meningite meningocócica do sorogrupo A

Neurologic and CSF evaluation in children with serogroup A meningococcal meningitis

Resumos

Este trabalho aborda o estudo clínico e a análise do LCR, em 255 crianças de zero a 12 anos de idade, com meningite por meningococo do sorogrupo A. Por ocasião da admissão hospitalar verificamos que 27 pacientes (10,59%) apresentavam intercorrências neurológicas, sendo que a intercorrência mais freqüente foi a manifestação epiléptica, com predomínio nos pacientes menores de 13 meses de idade. O óbito foi registrado em 11 pacientes (4,31%). No momento da alta hospitalar, 14 pacientes (5,49%) apresentavam anormalidades neurológicas, com prevalência para a surdez e a ataxia, com exceção dos pacientes menores de 13 meses de idade, nos quais predominou a involução neuropsicomotora. Em pacientes com meningite meningocócica, não há necessidade de exame do LCR, para que a antibioticoterapia seja interrompida.


Our aim is to present the results obtained from the evaluation of the neurological examination as well as chemical and cytologic data from the CSF obtained at the admission and discharge of 255 children aged between zero and 12 years with a diagnosis of serogroup A meningococcal meningitis made at the Hospital Emilio Ribas in São Paulo, Brasil, in the years of 1976 and 1977. By the time of their admission, 27 patients (10,59%) showed positive neurologic findings besides meningeal signs. Seizures were the most common ones, with higher incidence in children under 13 months; ataxia, deafness, motor deficits, neuro-psychmotor involution, subdural effusions and disturbed behavior followed in that order. Subdural effusions were found only in those under 13 months. A fatal outcome was registered in eleven (4,31%) patients, of which nine died in the first 24 hours after admission. By the time of hospital discharge 14 patients (5,49%) had neurological abnormalities, deafness and ataxia being the most common ones, in the older patients. Under 13 months, developmental involution predominated. There is no need of CSF evaluation for antibiotic therapy interruption in patients with meningococcal meningitis.


Avaliação neurológica e do líquido cefalorraqueano em crianças com meningite meningocócica do sorogrupo A

Neurologic and CSF evaluation in children with serogroup A meningococcal meningitis

A. U. Bresolin

Médico Chefe da Seção de Diagnóstico e Terapêutica do Serviço de Neurologia do Hospital do Servidor Público de São Paulo e Neuropediatra do Hospital Emilio Ribas

RESUMO

Este trabalho aborda o estudo clínico e a análise do LCR, em 255 crianças de zero a 12 anos de idade, com meningite por meningococo do sorogrupo A. Por ocasião da admissão hospitalar verificamos que 27 pacientes (10,59%) apresentavam intercorrências neurológicas, sendo que a intercorrência mais freqüente foi a manifestação epiléptica, com predomínio nos pacientes menores de 13 meses de idade. O óbito foi registrado em 11 pacientes (4,31%). No momento da alta hospitalar, 14 pacientes (5,49%) apresentavam anormalidades neurológicas, com prevalência para a surdez e a ataxia, com exceção dos pacientes menores de 13 meses de idade, nos quais predominou a involução neuropsicomotora. Em pacientes com meningite meningocócica, não há necessidade de exame do LCR, para que a antibioticoterapia seja interrompida.

SUMMARY

Our aim is to present the results obtained from the evaluation of the neurological examination as well as chemical and cytologic data from the CSF obtained at the admission and discharge of 255 children aged between zero and 12 years with a diagnosis of serogroup A meningococcal meningitis made at the Hospital Emilio Ribas in São Paulo, Brasil, in the years of 1976 and 1977. By the time of their admission, 27 patients (10,59%) showed positive neurologic findings besides meningeal signs. Seizures were the most common ones, with higher incidence in children under 13 months; ataxia, deafness, motor deficits, neuro-psychmotor involution, subdural effusions and disturbed behavior followed in that order. Subdural effusions were found only in those under 13 months. A fatal outcome was registered in eleven (4,31%) patients, of which nine died in the first 24 hours after admission. By the time of hospital discharge 14 patients (5,49%) had neurological abnormalities, deafness and ataxia being the most common ones, in the older patients. Under 13 months, developmental involution predominated. There is no need of CSF evaluation for antibiotic therapy interruption in patients with meningococcal meningitis.

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Resumo da Dissertação para Mestrado, Área de Neurologia do Curso de Pós Graduação da Faculdade de Medicina da Universidade de São Paulo.

Hospital Emilio Ribas - Av. Dr. Arnaldo - São Paulo, SP - Brasil.

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Datas de Publicação

  • Publicação nesta coleção
    14 Ago 2012
  • Data do Fascículo
    Dez 1983
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