Abstract

ACUTE BACTERIAL MENINGITIS IN PATIENTS ADMITTED TO THE CHILDREN HOSPITAL IN DAMASCUS, SYRIA

Groob Alkhayer, Mhd Nezar Alsharif* and Maiass El Homsi

Abstract

Objective: This study aimed to determine the most common age, presentation (symptoms and signs) of acute bacterial meningitis (ABM) for each age group, the most common pathogens responsible for it and the cerebrospinal fluid (CSF) analysis of ABM cases.Methods: This is a retrospective study composed of 55 children (newborns until 12 years old); who reviewed the Children University Hospital Between 1/1/2015 and 20/11/2017 and were diagnosed with acute bacterial meningitis. Results: This study included 55 patients.Most of the participants were boys between (1 month -6 months) old. The most common results of CSF culture in our study were sterile (23cases of all patients). In addition, the most common pathogen was Streptococcus pneumoniae (13 cases of all patients). The most common symptom-sign for each age group (<month, 1 month-6 months, 6 months- 1 year, 1 year- 6 years and 6 years- 12 years) was (poorbreastfeeding-hyperreflexia, poor breastfeeding and convulsion equally-bulging fontanelle,fever- bulging fontanelle, fever- positive Neck Stiffness, upper Brudzinski, lower Brudzinski,Kernig equally and fever-neck stiffness, upper Brudzinski equally), respectively. CSFanalysis revealed 23.6% of all patients had a WBC count (more than 100 cell/mm3), 18.1%had polymorph nuclear neutrophils dominance and 38.2% had low glucose levels in the CSF.All of the following opposes the diagnosis of bacterial meningitis and suggests differentcauses of meningitis. This could be related to incomplete or incorrect previous antibiotictherapy. Conclusion: We found that acute bacterial meningitis (ABM) is most common inboys between (1 month- 6 months) old. The most common pathogen causing ABM isstreptococcus pneumoniae while the most common culture result was sterile. The mortalityrate in our study was 21.8% (12 patients).

Keywords: Acute bacterial meningitis (ABM); Children Hospital; ABM pathogens; CSF analysis.