Presentation And Outcome Of Pyogenic Meningitis In Children: The Experience In Nnewi, Southeast Nigeria

Abstract

Background: Despite the availability of potent antimicrobial agents, bacterial meningitis continues to carry a high mortality rate. An appreciable number of survivors are affected by neurological deficits, epilepsy and mental retardation. Objectives: To determine the morbidity and mortality patterns of children admitted for bacterial meningitis at the Nnamdi Azikiwe University Teaching Hospital, Nnewi. Design: Retrospective, descriptive Patients and Methods: The medical records of 31 children treated for bacterial meningitis from January 1998 to December 2001 were reviewed Results: 31 children aged 2 months to 14 years, out of a total of 4474 patients, were treated for meningitis (0.69% prevalence rate). Median age was 5 years, with 29% less than 12 months and 45% less than 24 months old. Sex ratio was male 1.4: female 1. Most frequent presenting features were fever, neck stiffness and convulsions. There was a low microbial yield on culture due to prior antibiotic exposure. Treatment was with combinations of ampicillin and chloramphenicol or Penicillin G and chloramphenicol or ceftazidime. 64.5% of patients were discharged well and 32.3% with neurological sequelae. There was one mortality (case fatality 3.2%). 46% of patients were subsequently lost to follow-up. Conclusion: Unrestricted abuse of antibiotics poses a problem in the laboratory diagnosis of bacterial meningitis in this area. Keywords: bacterial meningitis, childhood, morbidity, mortality, sequelae Tropical Journal of Medical Research Vol. 10 (2) 2006: pp. 22-25