Diagnostic value of auxiliary examination for childhood purulent meningitis complicated with subdural effusion

Abstract

Objective To explore the clinical and peripheral blood characteristics of childhood purulent meningitis complicated with subdural effusion. Methods A retrospective cohort chart review was performed.A total of 162 consecutive cases of purulent meningitis were identified in Shenzhen Children's Hospital from January 2009 to December 2013, all of them were divided into 2 groups according to whether complicating with subdural effusion, and the clinical characteristics of 2 groups were analyzed.The clinical characteristics were analyzed.The statistical data were determined by SPSS 17.0 software. Results Forty-nine cases(30.25%)of them were complicated with subdural effusion; and 37 cases (75.5%)of them suffered from the disease in the first 10 days after the onset of the meningitis, and the incidence was 48.84% (42 cases) in infancy.Fever, lethargy, seizures and bulging fontanelle were its common clinical signs, and there were no significant differences in the incidence between subdural effusion group and the control group(non-subdural effusion group), the white blood cell (WBC) count did not increase markedly and C-reactive protein(CRP) was high in the subdural effusion group on the admission day(Z=1.74, 2.10, all P<0.05), but no difference in platelet(PLT). The PLT was high in the whole meningitis cohort, the ratio of cases whose PLT was higher than 300×109/L reached 93.75%, but no difference between the 2 groups. There were many factors of WBC on admission, including age, cerebrospinal fluid culture results and the application of antibiotics before admission, but CRP was only affected by antibiotics. Conclusions Subdural effusion is common in infancy, and most occurred in the first 10 days after onset of the meningitis.On admission day the CRP, was high, while WBC did not increase too much. If CRP rises for the second time it might predict the occurrence of subdural effusion in bacterial meningitis.The increased PLT may be considered as clinical feature of infectious diseases.The clinical implication of inflammatory pathophysiology in meningitis needs further investigation. Key words: Purulent meningitis; Subdural effusion; Child; White blood cell count; C-reactive protein; Platelet