Acute Neurologic Complications And Long Term Sequelae Of Bacterial Meningitis In Children

Abstract

Mortality and morbidity rates are high among children with acute bacterial meningitis, especially in young ages. A im: to determine the most common neurologic complications during the acute phase of childhood bacterial meningitis and long term sequelae. Material and methods: A total of 277 children (aged 0-16years) were evaluated for acute neurologic complications following bacterial meningitis at the Infectious Diseases Clinic in Prishtina (Kosovo) in years 1997-2002. The authors have analyzed the sequelae that persisted during the three year follow-up period. Results: Of the 277 children treated for bacterial meningitis, 60 children developed neurologic complications (22%) and 15 died (5%). The acute neurologic complications observed were: subdural effusion (35), seizures (31), hydrocephalus (7), 2 cases of subdural empyema and single case of spinal abscess, quadriparesis, vision loss, cerebritis, subdural hematoma and intracerebral hemorrhage. Fifteen children (5%) underwent neurosurgical intervention: 6 children with subdural effusion, 5 with obstructive hydrocephalus, 2 with subdural empyema and one child with subdural haematoma. Long term sequelas were observed in 28 patients (10%): late seizures (24), hydrocephalus (5), deafness (3) neuropsychological impairment (3) and a single case with quadriparesis and partial amaurosis. Conclusion: Neurologic complications of bacterial meningitis are frequent with subdural effusion being the most common during the acute phase of meningitis. Half of neurologic complications resolved within three years of follow up: only 10% of children were left with long term sequelae with late seizures being the most common.