Bor Meltem, Çokuğraş Haluk
Department of Pediatrics, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey.
Division of Pediatric Allergy and Immunology, Department of Pediatrics, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey.
Turk Pediatri Ars. 2020 Jun 19;55(2):149-156. doi: 10.14744/TurkPediatriArs.2019.34445. eCollection 2020.
To evaluate factors associated with the development of early complications in acute bacterial meningitis.
In our study, 389 patients diagnosed with acute bacterial meningitis between January 1992 and January 2011 at Cerrahpaşa Medical Faculty were retrospectively analyzed to determine the risk factors for the development of early complications.
The causative agent was in 17% of cases, S. pneumoniae in 13.6%, and in 6.4%. In 55.5% of cases, the causative agent could not be identified. The mortality rate was found as 1% and the early complication rate was 27.8%. The complications observed included septic shock and disseminated intravascular coagulation (33.3%), hydrocephalus (23.1%), subdural effusion (19.4%), and epilepsy (12%). Risk factors for early complications included being aged below two years (p<0.010), restlessness (p<0.010), rash (p<0.010), leukocytosis in complete blood count (p<0.010), and a cerebrospinal fluid glucose level of <45 mg/dL (p<0.010). Three of the four patients who died were male. The incidence of hydrocephalus was higher in patients who used ampicillin-cefotaxime and who did not receive steroid therapy before treatment (p<0.050).
When acute bacterial meningitis is treated properly and adequately, recovery without sequela is possible. Knowing the risk factors for early complications will guide in the monitoring of patients and decrease morbidity and mortality rates.
评估急性细菌性脑膜炎早期并发症发生的相关因素。
在我们的研究中,对1992年1月至2011年1月期间在切拉帕夏医学院诊断为急性细菌性脑膜炎的389例患者进行回顾性分析,以确定早期并发症发生的危险因素。
17%的病例病原体为[此处原文缺失具体病原体名称],13.6%为肺炎链球菌,6.4%为[此处原文缺失具体病原体名称]。55.5%的病例无法确定病原体。死亡率为1%,早期并发症发生率为27.8%。观察到的并发症包括感染性休克和弥散性血管内凝血(33.3%)、脑积水(23.1%)、硬膜下积液(19.4%)和癫痫(12%)。早期并发症的危险因素包括年龄小于两岁(p<0.010)、烦躁不安(p<0.010)、皮疹(p<0.010)、全血细胞计数白细胞增多(p<0.010)以及脑脊液葡萄糖水平<45mg/dL(p<0.010)。死亡的4例患者中有3例为男性。使用氨苄西林 - 头孢噻肟且治疗前未接受类固醇治疗的患者脑积水发生率较高(p<0.050)。
当急性细菌性脑膜炎得到适当且充分的治疗时,有可能无后遗症康复。了解早期并发症的危险因素将有助于指导对患者的监测并降低发病率和死亡率。