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. 2025 May 19;51(1):145.
doi: 10.1186/s13052-025-01995-9.

Clinical characteristics and post-operative outcomes in children with purulent meningitis with hydrocephalus: 46 cases in a single center study

Yaning Sun #  1 , Juan Du #  2 , Jiangshun Fang  2 , Shengjuan Wang  2 , Jimei Luan  2 , Zhenghai Cheng  2 , Zhiguo Yang  2 , Yishuo Sun  3
Affiliations

Clinical characteristics and post-operative outcomes in children with purulent meningitis with hydrocephalus: 46 cases in a single center study

Yaning Sun et al. Ital J Pediatr. .

Abstract

Background: To investigate the clinical characteristics, surgical strategy, and surgical outcomes in children with purulent meningitis with hydrocephalus (PMH) under 3 years old.

Methods: This retrospective controlled study included 46 pediatric patients who underwent the Conventional external ventricular drain (C-EVD) or modified external ventricular drainage (M-EVD) for PMH treatment at Hebei Province of Children's Hospital from January 2018 to December 2023. Conventional external ventricular drain placement is standard of care in the management of purulent meningitis with hydrocephalus. The indwelling time of conventional external ventricular drainage is relatively short, 7-10 days. Long-term external drainage devices may lead to retrograde infection. This study has modified the external ventricular drain procedure. Clinical outcomes, cerebrospinal fluid (CSF) test results, complications, and outcomes were compared between the modified external ventricular drainage (n = 21) group and conventional external ventricular drain (n = 25) group.

Results: The two groups were similar regarding age, sex, weight and other general conditions (P > 0.05). There were significant differences in the values of white blood cells (WBC), glucose (GLU) and protein (PR) in cerebrospinal fluid between the two groups when the drainage tube was removed, which was statistically significant. The median days of removing the drainage tube in the conventional external ventricular drain group and the modified external ventricular drainage group were 9 days and 19 days, respectively. The median days of CSF returning to normal were 19 days and 13 days (P < 0.05). A total of 13 children in the modified external ventricular drainage group underwent ventriculo-peritoneal shunt surgery, while 17 children in the conventional external ventricular drain group were treated with entriculo-peritoneal shunt surgery (P = 0.665).

Conclusion: The modified external ventricular drainage has more obvious advantages compared to conventional external ventricular drain. The modified significantly prolonged the catheterization time, which can more effectively treat purulent meningitis with hydrocephalus in pediatric patients.

Keywords: Conventional; External ventricular drainage; Hydrocephalus; Modified; Pediatric; Purulent meningitis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was in accordance with the Helsinki Declaration and was approved by the institutional review board of Hebei Children’s Hospital. All participants obtained consent from their parents and legal guardians and signed informed consent forms. Consent for publication: Written informed consent was obtained from all parents and legal guardians to authorize the publication of their data. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
(A) The puncture position of M-EVD group. (B) The position of the drainage tube in the M-EVD group
Fig. 2
Fig. 2
The puncture position of C-EVD group
See this image and copyright information in PMC

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