Namani Sadie A, Koci Bulëza M, Milenković Zvonko, Koci Remzie, Qehaja-Buçaj Emine, Ajazaj Lindita, Mehmeti Murat, Ismaili-Jaha Vlora
Infectious Diseases Clinic, University Clinical Center of Kosovo, University of Prishtina, Hil-Mosi 3A., Prishtina, Kosovo.
Childs Nerv Syst. 2013 Feb;29(2):275-80. doi: 10.1007/s00381-012-1917-3. Epub 2012 Sep 12.
Since neurologic complications of childhood bacterial meningitis are encountered frequently despite antibiotic treatments, the purpose of this study was to analyze early neurologic complications and long-term sequelae of bacterial meningitis in children in a limited-resource country (Kosovo)
This study uses a retrospective chart review of children treated for bacterial meningitis in two study periods: 277 treated during years 1997-2002 and 77 children treated during years 2009-2010.
Of the 277 vs 77 children treated for bacterial meningitis, 60 (22%) vs 33 (43%) patients developed early neurologic complications, while there were 15 (5.4%) vs 2 (2.6%) deaths. The most frequent early neurologic complications were the following: subdural effusions (13 vs 29%), recurrent seizures (11 vs 8%), and hydrocephalus (3 vs 3%). The relative risk (95% confidence interval) for neurologic complications was the highest in infants (3.56 (2.17-5.92) vs 2.69 (1.62-4.59)) and in cases caused by Haemophilus influenzae 1.94 (1.09-3.18) vs Streptococcus pneumoniae 2.57(1.26-4.47). Long-term sequelae were observed in 10 vs 12% of children, predominantly in infants. The most frequent long-term sequelae were late seizures 9 vs 1%, neuropsychological impairment 1 vs 5%, and deafness 1 vs 3%.
In both study periods, the most frequent early neurologic complications of childhood bacterial meningitis were subdural effusions. Long-term sequelae were observed in 10% of children, with late seizures, neuropsychological impairment, and deafness being the most common one. Age prior to 12 months was risk factor for both early neurologic complications and long-term sequelae of bacterial meningitis in children.
尽管采用了抗生素治疗，但儿童细菌性脑膜炎的神经系统并发症仍屡见不鲜。本研究旨在分析资源有限国家（科索沃）儿童细菌性脑膜炎的早期神经系统并发症及长期后遗症。
本研究采用回顾性病历审查，涉及两个研究阶段接受细菌性脑膜炎治疗的儿童：1997年至2002年期间治疗的277例以及2009年至2010年期间治疗的77例。
在接受细菌性脑膜炎治疗的277例和77例儿童中，分别有60例（22%）和33例（43%）出现早期神经系统并发症，死亡病例分别为15例（5.4%）和2例（2.6%）。最常见的早期神经系统并发症如下：硬膜下积液（13%对29%）、癫痫复发（11%对8%）和脑积水（3%对3%）。神经系统并发症的相对风险（95%置信区间）在婴儿中最高（3.56（2.17 - 5.92）对2.69（1.62 - 4.59）），在由流感嗜血杆菌引起的病例中为1.94（1.09 - 3.18），而肺炎链球菌引起的病例为2.57（1.26 - 4.47）。10%对12%的儿童出现长期后遗症，主要见于婴儿。最常见的长期后遗症是晚期癫痫9%对1%、神经心理障碍1%对5%和耳聋1%对3%。
在两个研究阶段，儿童细菌性脑膜炎最常见的早期神经系统并发症均为硬膜下积液。10%的儿童出现长期后遗症，其中晚期癫痫、神经心理障碍和耳聋最为常见。12个月前的年龄是儿童细菌性脑膜炎早期神经系统并发症和长期后遗症的危险因素。
