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. 2020 Jun 19;55(2):149-156.
doi: 10.14744/TurkPediatriArs.2019.34445. eCollection 2020.

Factors associated with early complications in inpatients who were treated in our clinic between 1992 and 2011 with a diagnosis of acute bacterial meningitis

Meltem Bor  1 , Haluk Çokuğraş  2
Affiliations

Factors associated with early complications in inpatients who were treated in our clinic between 1992 and 2011 with a diagnosis of acute bacterial meningitis

Meltem Bor et al. Turk Pediatri Ars. .

Abstract
in English, Turkish

Aim: To evaluate factors associated with the development of early complications in acute bacterial meningitis.

Material and methods: 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.

Results: The causative agent was N. meningitidis in 17% of cases, S. pneumoniae in 13.6%, and H. influenzae type b 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).

Conclusion: 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.

Amaç: Akut bakteriyel menenjitte erken komplikasyon gelişimi ile ilişkili etmenleri değerlendirmek.

Gereç ve yöntemler: Çalışmamızda Cerrahpaşa Tıp Fakültesi’nde Ocak 1992–Ocak 2011 tarihleri arasında akut bakteriyel menenjit tanısı konulan 389 olgu erken komplikasyon gelişimi için risk etmenlerin belirlenmesi amacıyla geriye dönük olarak incelendi.

Bulgular: Değerlendirilen olguların %17’si N. meningitidis, %13,6’sı S. pneumoniae, %6,4’ü H. influenzae tip b menenjiti idi, %55,5’inde etken saptanamadı. Ölüm oranı %1, erken komplikasyon %27,8 oranındaydı. Komplikasyonlar sıklık sırasıyla septik şok ve dissemine intravasküler koagülasyon (%33,3), hidrosefali (%23,1), subdural efüzyon (%19,4) ve epilepsi (%12) idi. Erken komplikasyonlar için risk etmenleri iki yaş altında olma (p<0,010), huzursuzluk (p<0,010), döküntü (p<0,010), serumda lökositoz (p<0,010), beyin omurilik sıvısı glukozunun <45 mg/dl olması (p<0,010) olarak saptandı. Ölen dört olgudan üçü erkekti. Ampisilin-sefotaksim kullanılanlarda ve tedavi öncesi steroid verilmeyen olgularda hidrosefali gelişme oranı yüksekti (p<0,050).

Çikarimlar: Akut bakteriyel menenjit doğru ve yeterli tedavi edildiğinde sekelsiz iyileşme mümkündür. Erken komplikasyonlar için risk etmenlerinin bilinmesi hastanın izlenmesinde yol gösterici olup, hastalık ve ölüm oranını azaltacaktır.

Keywords: Bacterial; complication; meningitis; prognosis.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Distribution of the causative agents by years (n=389)
See this image and copyright information in PMC

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