SciELO - Scientific Electronic Library Online

 
vol.87 issue6Breaking barriers: a competency-based framework for promoting the integration of the pediatrician's educationPerception of dyspnea in childhood asthma crisis by the patients and those in charge of them author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Jornal de Pediatria

Print version ISSN 0021-7557

Abstract

ANTONIUK, Sérgio A. et al. Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae. J. Pediatr. (Rio J.) [online]. 2011, vol.87, n.6, pp. 535-540. ISSN 0021-7557.  http://dx.doi.org/10.2223/JPED.2138.

OBJECTIVE: To assess acute neurological complications and neurological sequelae of childhood acute bacterial meningitis in order to determine possible warning signs. METHODS: This retrospective study evaluated children with acute bacterial meningitis (between 1 month and 14 years of age) admitted between 2003 and 2006. RESULTS: Of the 44 patients studied, 17 (38.6%) had acute neurological complications. Seizure was the most frequent (31.8%) complication. Patients with acute neurological complications showed a higher frequency of lower neutrophil count (p = 0.03), seizure at admission (p < 0.01), and S. pneumoniae as the etiologic agent (p = 0.01). Risk factors for the development of acute neurological complications were S. pneumoniae (odds ratio [OR] = 6.4, confidence interval [CI] 1.7-24.7) and neutrophil count < 60% (p < 0.01). Of the 35 patients who were followed up, 14 had neurological sequelae (40%). Behavioral change (22.9%) was the most frequent sequela. Seizures at admission (OR = 5.6, CI 1.2-25.9), cerebrospinal fluid protein concentration > 200 mg/dL (p < 0.01), and cerebrospinal fluid glucose concentration/glycemia ratio (p < 0.01) were identified as risk variables for sequelae. CONCLUSION: Neutrophil count < 60%, seizure at admission, and S. pneumoniae as the etiologic agent were identified as warning signs for acute neurological complications, while protein levels, cerebrospinal fluid glucose concentration/glycemia ratio, and seizure at admission were seen as risk factors for neurological sequelae.

Keywords : Bacterial meningitis; neurological complications; neurological follow-up; pediatrics.

        · abstract in Portuguese     · text in English | Portuguese     · pdf in English | Portuguese