Abstract
Haemophilus influenzae meningitis has been associated with anemia. Although the mechanism of this anemia has not been investigated, accelerated red cell destruction has been assumed because of the rapid decrease in hemoglobin in the absence of bleeding. To further define this pathophysiology, the RCD of patients with meningitis was studied by measuring the filtration time of washed red cells through polycarbonate filters. Eleven patients with Haemophilus influenzae meningitis, 3 with meningococcal meningitis, 9 with aseptic meningitis and 30 normal children were studied. The filtration time of the Haemophilus influenzae meningitis group (81.2 ± 96.1 secs) was significantly prolonged (P < 0.01) compared to the aseptic group (24.7 ± 6.4) and a group of normals (24.1 ± 5.3). The 3 children with meningococcal meningitis had filtration times of 73.5, 18.7 and 34.9 secs. Only 3 of 11 Haemophilus influenzae meningitis subjects fell within the normal range. Nine of 14 patients with bacterial meningitis were anemic versus 1/9 in the aseptic group. This study demonstrates that RCD is significantly diminished in children with bacterial meningitis. This decreased deformability may result in a diminished red cell survival and account for the postulated hemolytic anemia associated with this illness. The mechanism by which the RCD is altered remains to be elucidated.
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