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Abstract

Background and aims: Globally, meningitis can lead to a high rate of death and disability in children. Aims: Our aim was to assess the clinical and laboratory features of children with a diagnosis of meningitis in emergency department. Methods: The children admitted to the emergency department with clinically suspected of meningitis and with abnormal cerebrospinal fluid findings (CSF: ≥ 10 WBC per mm3) was included the study. Bacterial meningitis was considered if any following criteria were met in a child with positive CSF culture or positive gram stain. The WHO definition for probable meningitis (CSF with ≥ 100 WBC per mm3, 10–99 WBC per mm3 plus protein concentration ≥100 mg/dL or glucose <40 mg/dL) and high Bacterial Meningitis Score (high BMS= CSF ≥ 10 WBC per mm3 with positive gram stain, CSF neutrophil count ≥ 1000 cells/ mm3, CSF protein ≥100 mg/dL or seizure before or at presentation) were used. Results: A total of 190 children with abnormal CSF findings were included the study. They were classified as aseptic (171, 90%) and bacterial (19, 10%) meningitis. Bulging fontanelle and headache were more common in bacterial meningitis group (p<0.05). Blood procalcitonin levels were higher and CSF glucose levels were lower in bacterial meningitis group (p<0.05). The rate of probable meningitis and high BMS were not different in the groups (p>0.05). In logistic regression analysis, there was no significant parameter for bacterial meningitis diagnosis (p<0.05). Conclusions: Signs, symptoms, proposed criteria for high suspicion of bacterial meningitis, and laboratory findings at admission are not helpful for diagnosis of bacterial meningitis.