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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.54 no.1 São Paulo Mar. 1996

http://dx.doi.org/10.1590/S0004-282X1996000100013 

Meningite bacteriana neonatal: estudo prospectivo da evolução a longo prazo de 55 crianças

 

Neonatal bacterial meningitis: prospective study of the long term outcome of 55 children

 

 

Vera Lúcia Jornada KrebsI; Edna Maria de Albuquerque DinizII; Flávio Adolfo Costa VazIII; Maria Joaquina Marques DiasIV; Clóvis TakigutiV; José Lauro Araújo RamosVI

IDoutora em Pediatria (USP), Médica-Assistente da Unidade de Cuidados Intensivos para Recém-nascidos Externos (UCIRNE) de ICr do HC/FMUSP
IIProfessora Livre-Docente em Pediatria Neonatal (USP), responsável pela UCIRNE do ICr do HC/FMUSP
IIIProfessor-Associado do Departamento de Pediatria da FMUSP, Diretor do Serviço de Pediatria Neonatal do HC/FMUSP
IVDoutora em Neurologia (USP), Chefe da Unidade de Neuropediatria do ICr HC/FMUSP
VProfessor-Associado do Departamento de Medicina Preventiva da FMUSP
VIProfessor Titular do Departamento de Pediatria da FMUSP

 

 


RESUMO

Foram estudadas prospectivamente 55 crianças que apresentaram meningite bacteriana no período neonatal, com o objetivo da analisar a frequência e o tipo de sequelas neurológicas. Todas as crianças nasceram a termo, sendo 38 do sexo masculino e 17 do feminino; a idade de início da doença variou de 3 a 28 dias. Os principais agentes etiológicos foram as enterobactérias. O tempo médio de seguimento foi 5 anos. A frequência de sequelas neurológicas foi 67,3%, representadas principalmente pelo atraso do desenvolvimento neuropsicomotor (58,2%), hidrocefalia (45,5%) e convulsões (34,5%). As alterações motoras graves ocorreram em 23,6% dos pacientes (tetraplegia, diplegia, hemiparesia e ataxia). As convulsões na fase aguda da doença e a cultura positiva do líquido cefalorraqueano estiveram associadas significativamente com a presença de sequelas. Na avaliação do desempenho escolar, realizada em 25 crianças, observaram-se dificuldades na aprendizagem em 48% dos casos, associadas significativamente à deficiência mental.

Palavras-chave:recém-nascido, meningite, seguimento.


ABSTRACT

Fifty-five infants who presented bacterial neonatal meningitis were prospectively studied to analyze the frequency and the type of sequelae. All the infants were full term newborns.There were 38 boys and 17 girls; the age of disease onset varied from 3 to 28 days. The causative organism was represented mainly by enterobacteriae. The median time of follow-up was 5 years. The frequency of neurologic sequelae was 63.7%, represented mainly by neuropsychomotor development delay (58.2%), hydrocephaly (45.5%) and convulsions (34.5%). Severe motor abnormalities ocurred in 23.6% of children (quadriplegia, diplegia, hemiparesia and ataxia). Convulsions in the acute phase of the disease and the positive cerebrospinal fluid culture were highly associated to sequelae. The school performance, obtained in 25 children, showed presence of disabilities in 48% of cases, which were significantly associated to mental retardation.

Key words:meningitis, newborn, follow-up.


 

 

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Aceite: 10-outubro-1995

 

 

Instituto da Criança (ICr) do Hospital das Clínicas (HC) da Faculdade de Medicina (FM) da Universidade de São Paulo (USP)
Dra. Vera Lúcia Jornada Krebs - Instituto da Criança HC/FMUSP - Av. Dr. Enéas de Carvalho Aguiar 647 -05403-000 São Paulo SP Brasil. FAX 011 853 2602.

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