Department of Pediatric Infectious Diseases, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey.
Department of Pediatric Infectious Diseases, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
BMC Pediatr. 2024 Nov 25;24(1):765. doi: 10.1186/s12887-024-05255-3.
Acute central nervous system (CNS) infections in children can lead to neurological complications and mortality. This study aimed to identify the clinical manifestations, laboratory parameters, and cerebrospinal fluid characteristics indicative of CNS infections and define the risk factors that lead to pediatric intensive care unit (PICU) admission in the pediatric population of Şanlıurfa, a city in southeastern Turkey.
This retrospective analysis included patients aged 1 month to 18 years who were treated for acute CNS infections in the Şanlıurfa Training and Research Hospital between January 2020 and May 2023. Clinical data were obtained from the hospital electronic medical records.
A total of 68 patients with acute CNS infections were included in this study. The median patient age was 3 (0.94-8.75) years. Fever was the most prevalent symptom in 92.6% of the patients. Of the total, 25% (n = 17) of the patients had an identified causative agent and 35.3% (n = 24) were admitted to the PICU. Serum C-reactive protein (CRP) levels were significantly higher in patients with bacterial meningitis than in those with viral meningitis (p = 0.007). Patients with impaired consciousness and seizure were significantly more likely to require admission to the PICU than patients without these conditions (both p < 0.001). Patients requiring PICU admission had significantly higher platelet counts (p = 0.01).
Impaired consciousness, seizure, and thrombocytosis on admission were important risk factors for PICU admission. Serum CRP levels can serve as an indicator of bacterial meningitis. A combination of physical findings from clinical evaluations and laboratory data is necessary to accurately diagnose bacterial CNS infections.
儿童急性中枢神经系统（CNS）感染可导致神经并发症和死亡。本研究旨在确定提示中枢神经系统感染的临床症状、实验室参数和脑脊液特征，并确定导致土耳其东南部城市尚勒乌尔法儿科人群入住儿科重症监护病房（PICU）的危险因素。
本回顾性分析纳入了 2020 年 1 月至 2023 年 5 月在尚勒乌尔法培训和研究医院因急性中枢神经系统感染接受治疗的 1 个月至 18 岁儿童患者。临床数据来自医院电子病历。
本研究共纳入 68 例急性中枢神经系统感染患儿。中位患者年龄为 3（0.94-8.75）岁。92.6%的患者有发热症状。在所有患者中，25%（n=17）有明确的病原体，35.3%（n=24）入住 PICU。细菌性脑膜炎患者的血清 C 反应蛋白（CRP）水平明显高于病毒性脑膜炎患者（p=0.007）。有意识障碍和癫痫发作的患者比无这些情况的患者更有可能需要入住 PICU（均 p<0.001）。需要入住 PICU 的患者血小板计数明显较高（p=0.01）。
入院时意识障碍、癫痫发作和血小板增多是入住 PICU 的重要危险因素。血清 CRP 水平可作为细菌性脑膜炎的指标。需要结合临床评估的体格检查结果和实验室数据来准确诊断细菌性中枢神经系统感染。
