Sallam Abdul Khaliq A
Department of Peadiatrics, Al-Thawrah Teaching Hospital, Sana'a, Yemen.
J Ayub Med Coll Abbottabad. 2004 Oct-Dec;16(4):40-3.
This study was carried out to determine the etiology and management outcome of acute bacterial meningitis among children presenting at Al-Thawrah hospital, Sana'a, Yemen.
This study was carried out from 01/01/2001 to 23/08/2002. It initially included 77 children of all ages (newborn to 12 years), who attended pediatric emergency with fever, convulsions and altered sensorium. Full medical history. clinical examination and lab investigations were used to diagnose acute bacterial meningitis, and to summarize etiology, presentation and management outcome.
Over this 20 months period only 63 (81.81%) out of 77 suspected children were diagnosed as acute bacterial meningitis (ABM). The most affected age group was 4 months and 3 years. Based on CSF exam; there were 23 with positive findings of CSF analysis (turbid, decrease glucose <40mg.dl, increase protein >80mg.dl and leucocytes neutrophils >5cells.cu.mm), 21 cases were confirmed with CSF culture, while the remaining 19 cases showed normal CSF pictures. The fatality rate was 14.28%. The predominant organism in CSF culture was Klebsiella (33.33%) followed by Haemophilius influenza (23.80%), streptococcal pneumonia (14.28%) then 02 cases each; E-coli, Pseudomonas (09.52%) while with one cases each of tubercles meningitis and staphylococcus aureus.
Proper knowledge of etiology and presentation of ABM along with timely vaccination can help reduce mortality and morbidity associated with this deadly disease.
本研究旨在确定也门萨那市革命医院收治的儿童急性细菌性脑膜炎的病因及治疗结果。
本研究于2001年1月1日至2002年8月23日进行。最初纳入了77名各年龄段(新生儿至12岁)因发热、惊厥和意识改变到儿科急诊就诊的儿童。通过完整的病史、临床检查和实验室检查来诊断急性细菌性脑膜炎,并总结病因、临床表现及治疗结果。
在这20个月期间,77名疑似儿童中仅有63名(81.81%)被诊断为急性细菌性脑膜炎(ABM)。受影响最严重的年龄组为4个月至3岁。根据脑脊液检查;23例脑脊液分析有阳性结果(浑浊、葡萄糖降低<40mg/dl、蛋白质升高>80mg/dl且白细胞中性粒细胞>5个/mm³),21例脑脊液培养确诊,其余19例脑脊液检查结果正常。死亡率为14.28%。脑脊液培养中最主要的病原体是克雷伯菌(33.33%),其次是流感嗜血杆菌(23.80%)、肺炎链球菌(14.28%),然后各有2例大肠杆菌、铜绿假单胞菌(9.52%),而结核性脑膜炎和金黄色葡萄球菌各有1例。
正确了解急性细菌性脑膜炎的病因和临床表现并及时接种疫苗有助于降低与这种致命疾病相关的死亡率和发病率。