[Meningococcal meningitis:descriptive study of 76 cases in a pediatric hospital].

BACKGROUND

One of the principal causes of bacterial meningitis (BM) in children older than one month is Neisseria meningitidis (Nm). A quick diagnosis and an immediate treatment are considered essential for a good outcome. We propose this study with the purpose of evaluating the clinical and epidemiological characteristics of the patients with BM caused by Nm and analyzing the effect on the presentation and incidence of sequelae and/or complications of the time elapsed since the starting of symptoms and the beginning of the treatment.

METHODS

We performed a retrospective analysis of the clinical registers of 76 patients diagnosed as BM caused by Nm entered in the Hospital de Pediatria Pedro de Elizalde, Buenos Aires, Argentina, during the years 1992 and 1993. We investigated age, sex, date of entrance, first symptoms, biochemistry of cerebrospinal fluid (CSF), nutritional status, convulsions and/or complications, length of internation and conditions at discharge. Processing was done with Epi-info 5.0. Differences between qualitative variables were analyzed with chi 2 and differences between means with z-test.

RESULTS

Boys were majority; fever was the most frequent initial symptom; petechiae were less frequently found, specially among infants. 79% of the patients had CSF of purulent characteristics; 32.9% of the patients had complications during their evolution; its incidence raised up to 48% in infants. Lethality was 1.3%, 6.5% of the children had sequelae at the moment of discharge. The average time of internment was 13 days. There were no significant differences when different groups were compared according to their prior evolution time.

CONCLUSIONS

1. Petechiae and vomits were significantly less frequent in infants; 2) the incidence of complications was significantly higher in this last group; 3) no greater incidence of complications or sequelae was observed in patients whose previous period of evolution was longer than 48 hours; 4) in all groups of age we found insidious forms of starting, and 5) there were patients with CSF of normal biochemical characteristics in all groups considered independently of the time of evolution elapsed.