Management and complications of acute bacterial meningitis

[Neurological and cerebrospinal fluid evaluation in children with serogroup A meningococcal meningitis]

Our aim is to present the results obtained from the evaluation of the neurological examination as well as chemical and cytologic data from the CSF obtained at the admission and discharge of 255 children aged between zero and 12 years with a diagnosis of serogroup A meningococcal meningitis made at the Hospital Emilio Ribas in São Paulo, Brasil, in the years of 1976 and 1977. By the time of their admission, 27 patients (10,59%) showed positive neurologic findings besides meningeal signs. Seizures were the most common ones, with higher incidence in children under 13 months; ataxia, deafness, motor deficits, neuro-psychomotor involution, subdural effusions and disturbed behavior followed in that order. Subdural effusions were found only in those under 13 months. A fatal outcome was registered in eleven (4,31%) patients, of which nine died in the first 24 hours after admission. By the time of hospital discharge 14 patients (5,49%) had neurological abnormalities, deafness and ataxia being the most common ones, in the older patients. Under 13 months, developmental involution predominated. There is no need of CSF evaluation for antibiotic therapy interruption in patients with meningococcal meningitis.