Sfaihi Lamia, Kamoun Fatma, Kamoun Thouraya, Aloulou Hajer, Mezghani Sinda, Hammemi Adnen, Hachicha Mongia
Tunis Med. 2014 Feb;92(2):141-6.
The bacterial meningitis in children remains a worrisome affection both by its frequency and by its gravity.
describe the epidemiological, clinical and evolutionary data of bacterial meningitis in children aged between 3 months and 15 years.
we conducted a retrospective study of all cases of bacterial meningitis collected in the department of pediatrics of Hedi Chaker hospital, during a period of 6 years (2006-2011). We analyzed the files retrospectively and we studied the epidemiological data and the outcome.
Thirty cases of bacterial meningitis were recorded. The most frequent species were Streptococcus pneumoniae and Haemophilus influenzae followed by Neisseria meningitidis with respectively 43%, 40%, and 6% of cases. The yearly distribution of these bacteria showed an increase of the rate of the bacterial meningitis during the last 2 years. The average age of our patients was 1 year 6months (3 months-13 years). All the patients were vaccinated according to the Tunisian vaccination calendar; and none of them had pneumococcal vaccine or the Hib vaccine. The main clinical manifestations were fever (100 %), seizures (14 %) and vomiting (44 %). Bulging fontanel was noted in 15cas (55 %), somnolence in 11 cases (40 %) and axial hypotonia in 12 cases (44 %). In the outcome, the neurological sequelae were showed in eight patients (26%).
In our study, H. influenzae and S. pneumoniae were the main microorganisms responsible for bacterial meningitis. We strongly recommend the introduction pneumococcal vaccine in our vaccination calendar.
儿童细菌性脑膜炎无论是从发病频率还是严重程度来看,仍然是一种令人担忧的疾病。
描述3个月至15岁儿童细菌性脑膜炎的流行病学、临床和演变数据。
我们对赫迪·查克医院儿科在6年期间(2006 - 2011年)收集的所有细菌性脑膜炎病例进行了回顾性研究。我们回顾性分析了病历,并研究了流行病学数据和转归情况。
记录了30例细菌性脑膜炎病例。最常见的菌种是肺炎链球菌和流感嗜血杆菌,其次是脑膜炎奈瑟菌,分别占病例的43%、40%和6%。这些细菌的年度分布显示在过去两年中细菌性脑膜炎的发病率有所上升。我们患者的平均年龄为1岁6个月(3个月至13岁)。所有患者均按照突尼斯疫苗接种计划进行了接种;但他们中没有人接种过肺炎球菌疫苗或b型流感嗜血杆菌结合疫苗。主要临床表现为发热(100%)、惊厥(14%)和呕吐(44%)。15例(55%)出现囟门饱满,11例(40%)出现嗜睡,12例(44%)出现轴向肌张力减退。在转归方面,8名患者(26%)出现了神经后遗症。
在我们的研究中,流感嗜血杆菌和肺炎链球菌是细菌性脑膜炎的主要致病微生物。我们强烈建议在我们的疫苗接种计划中引入肺炎球菌疫苗。