Abstract

META-ANALYSIS: BACTERIAL MENINGITIS IN CHILDREN WITH A FIRST FEBRILE SEIZURE

Dr. Ziyad Faleh Alnofei*, Homam Talal Abdullah Alsharif, Sarah Obaid Dhafar, Saad Mohamed Saad Alharthi, Sultan Mohammed Saleh Alzahrani, Emad Marzouq Rashed Alsufyani, Amal Saleh hamdi Alsofyany, Abdulaziz Saeed Asiri and Rayan Khalid Almalki

Abstract

Background & Purpose: Seizures may be the sole presentation of bacterial meningitis in febrile babies. Seizures are the primary manifestation of meningitis in 16.7% of kids and in one-third of those sufferers, whereas meningeal signs and signs might not be obvious. Consequently, it is obligatory to exclude underlying meningitis in kids providing with fever and seizure previous to making the analysis of FS. The Aim of this work is to provide cumulative data about the prevalence of Bacterial Meningitis (BM) among children with a first seizure in the context of fever. Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify Pediatrics clinical trials, and prevalence studies, which studied the outcome of the prevalence of BM in young children presenting to emergency care with a first ‘‘seizure and fever’’. A meta-analysis was done using fixed and random-effect methods. The primary outcome was prevalence of BM. Secondary outcomes were prevalence of encephalitis and overall prevalence of CNS infections. Results: A total of 7 studies were identified involving 1414 patients. Regarding primary outcome measures, I2 (inconsistency) was 84% with highly significant Q test for heterogeneity (p < 0.01), so random-effects model was carried out; with overall pooled prevalence of Bacterial Meningitis = 2% (95% CI 0.5 to 4.4). Regarding secondary outcome measures, I2 (inconsistency) was 86% with highly significant Q test for heterogeneity (p < 0.01), so random-effects model was carried out; with overall pooled prevalence of encephalitis = 0.8% (95% CI to 3.6). I2 (inconsistency) was 95% with highly significant Q test for heterogeneity (p < 0.01), so random- effects model was carried out; with overall pooled prevalence of overall CNS infections = 4.2% (95% CI 0.12 to 13.5). Conclusion: To conclude, Meningitis is more common in patients less than 18 months presenting with febrile seizures.

Keywords: Bacterial Meningitis, Children, First Febrile Seizure.