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Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae.
MedLine Citation:
PMID:  22170227     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To assess acute neurological complications and neurological sequelae of childhood acute bacterial meningitis in order to determine possible warning signs.
METHODS: This retrospective study evaluated children with acute bacterial meningitis (between 1 month and 14 years of age) admitted between 2003 and 2006.
RESULTS: Of the 44 patients studied, 17 (38.6%) had acute neurological complications. Seizure was the most frequent (31.8%) complication. Patients with acute neurological complications showed a higher frequency of lower neutrophil count (p = 0.03), seizure at admission (p < 0.01), and S. pneumoniae as the etiologic agent (p = 0.01). Risk factors for the development of acute neurological complications were S. pneumoniae (odds ratio [OR] = 6.4, confidence interval [CI] 1.7-24.7) and neutrophil count < 60% (p < 0.01). Of the 35 patients who were followed up, 14 had neurological sequelae (40%). Behavioral change (22.9%) was the most frequent sequela. Seizures at admission (OR = 5.6, CI 1.2-25.9), cerebrospinal fluid protein concentration > 200 mg/dL (p < 0.01), and cerebrospinal fluid glucose concentration/glycemia ratio (p < 0.01) were identified as risk variables for sequelae.
CONCLUSION: Neutrophil count < 60%, seizure at admission, and S. pneumoniae as the etiologic agent were identified as warning signs for acute neurological complications, while protein levels, cerebrospinal fluid glucose concentration/glycemia ratio, and seizure at admission were seen as risk factors for neurological sequelae.
Sérgio A Antoniuk; Fátima Hamdar; Renata D Ducci; Ariane T F Kira; Mônica N L Cat; Cristina R da Cruz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Jornal de pediatria     Volume:  87     ISSN:  1678-4782     ISO Abbreviation:  J Pediatr (Rio J)     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-12-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985188R     Medline TA:  J Pediatr (Rio J)     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  535-40     Citation Subset:  IM    
Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
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