Frequency Of Meningitis Research Articles

“Frequency of Meningitis in Children Aged 06 Months to 59 Months Presenting with First Episode of Fits with Fever in Pediatric Emergency Department”

Objective: The study was aimed to determine the frequency of bacterial meningitis in children aged six months to 5 years presenting with fever and fits for the first time in emergency department. Materials and Methods: This cross sectional study was conducted at the Aga Khan Hospital Karachi and its secondary hospitals including Kharadar, Hyderabdad, Garden, Karimabad sites. Using a non-probability consecutive sampling method the data was collected from 135 children over a period of 12 month from august 2019 to April 2020. In this study, we included the male and female children aged between 6 month to 60 months, Children presenting with fever and first episode of seizure, CSF examination done prior for inclusion in the study. Results: Out of 135 children in the study, 71 (52.30%) children were male, 51(38.46%) were aged between 6months to 24 years, 55(40%) children were in age range 13 to 36 months, 69 (51.50 %) children were completely immunized, 33 (24.60 %) partially immunized. Out of of 135 children ,130 (96%) presents with fits less than 15 minutes duration, whereas 5(4%) children presented with fits more than 15 min duration. Among 50(37%) children who were meningitis positive, 8(6%) were bacterial, 13(10%) were viral and 29 (21%) were partially treated meningitis. Conclusion: Substantial number of children presented with seizures had meningitis. Significant proportion of unimmunized children presenting with seizures had meningitis. , 8(6%) reported with bacterial Meningitis Keywords: Febrile Seizures, Meningitis, Bacterial Meningitis

Frequency of meningitis in children 6-18 months of age presenting with 1st episode of seizure and fever at Sahiwal Teaching Hospital Sahiwal, Punjab, Pakistan.

Objectives: To determine the frequency of meningitis in children 6-18 months of age presenting with 1st episode of febrile seizure (FS). Study Design: Cross-sectional. Setting: Department of Pediatric Medicine, Sahiwal Teaching Hospital, Sahiwal. Period: October 2021 to April 2022. Material & Methods: Children with 1st simple FS of age 6 months to 18 months of either gender were included. After taking informed written consent from the child’s parents, lumbar puncture was done in each patient and cerebrospinal fluid (CSF) analysis and blood sample were sent to the institutional pathology laboratory for presence or absence of meningitis. Results: In a total of 156 children, mean age was 11.24±2.86 months while 94 (60.3%) children were between 6-12 months of age. There were 100 (64.1%) male and 56 (35.9%) female children. The frequency of meningitis was found in 16 (10.3%) patients. Conclusion: The frequency of meningitis in children with 1st episode of febrile seizure was high (10.3%).

Frequency of Meningitis in Neonatal Sepsis

Frequency of Meningitis in Neonatal Sepsis

Frequency of Meningitis in Neonates with Late Onset Sepsis in Sharif Medical City

Background: Bacterial sepsis and meningitis continue to be major causes of morbidity and mortality in newborns, particularly in premature infants. The present study was undertaken to know the incidence of meningitis in neonates with late onset sepsis. Aim: To determine the frequency of meningitis in neonates with late onset sepsis. Methods: A descriptive cross sectional study was conducted in department of pediatrics at sharif medical city Lahore, from 09-12-2019 to 08-06-2020. One hundred and forty four (144) neonates with late onset sepsis fulfilling the inclusion criteria were included in study. Meningitis was confirmed on lumbar puncture and managed as per hospital protocol. Mean & sd were presented for age, gender, duration of complain and weight. Frequency and percentage were computed for gender and meningitis. Results: Mean age, weight and duration of symptoms in infants with late onset sepsis were 19.50±0.12 days, 3.97±1.17 kg and 4.05±1.98 days. Majority of infants were male i.e. 63.89% (m:f;1:1.7). Mean wbc count of the infants with late onset sepsis was 29.78±9.32.majority of infants had less than 75% neutrophils (68.05%), positive crp (91.67%) and negative blood culture test (52.78%). Frequency of meningitis in neonates with late onset sepsiswas 34.02%. Conclusions: frequency of meningitis in neonates with late onset sepsis was high i.e. 34.02%. Key words: Meningitis; neonates; late onset sepsis

Comparison of Transthecal Approach With Traditional Conservative Approach for Primary Closure After Incidental Durotomy in Anterior Lumbar Tear.

Incidental durotomies (IDs) are frequent complications of spinal surgeries which are mostly posterior or lateral. Anterior IDs are rare; however, they may lead to severe complications. We compared the transthecal approach with the conservative approach for primary closure after durotomy in anterior lumbar dural tear to assess the efficacy of these approaches to decrease postsurgical complications and clinical outcomes. A total of 21 patients undergoing L2-S1 laminectomy with anterior ID were randomly divided into a transthecal group (n = 9) and a conservative group (n = 12) based on the surgical dural closure technique. Postoperative pseudomeningocele, wound infection, rootlet herniation, pneumocephalus, cerebrospinal fluid (CSF) leakage, headache, meningitis, in addition to surgery duration and length of hospitalization were examined and compared in both groups. The frequency of pseudomeningocele and CSF leakage in patients undergoing the transthecal approach was significantly lower than those undergoing the conservative approach (P = .045 and .008, respectively). Furthermore, although the differences in the frequency of meningitis, pneumocephalus, headache, and wound infection were not statistically significant between the 2 groups, the effect sizes of the comparison were obtained as 49.4, 19.8, 7.1, and 2.6, respectively. This indicated that the differences were clinically significant between the 2 groups. We found that the transthecal approach was significantly more successful in managing CSF leakage as well as its complications and clinical outcomes. However, further clinical trials with bigger sample sizes are needed to substantiate this claim.

Meningitis in neonates having late onset sepsis.

Objectives: Majority of the researchers reporting incidence and etiology surrounding neonatal sepsis along with meningitis are from developed countries while limited work is noticed from developing countries where overall burden of these disease are immense. The current study was aimed to determine the frequency of meningitis in children having late-onset sepsis (LOS). Study Design: Descriptive Case Series study. Setting: Department of Pediatrics Medicine, Nishter Medical University Multan and DHQ Teaching Hospital, Dera Ghazi Khan. Period: From July to December 2019. Material & Methods: A total of 206 neonates of both gender, older than 72 hours, admitted and diagnosed with sepsis were enrolled. Meningitis was labeled in a neonate if his/her cerebrospinal fluid (CSF) contains > 30 leukocytes/mm3, and any one of these two: protein >200mg/dl or sugar <40mg/dl. Results: Out of a total of 206 neonates having LOS, majority, 111 (53.9%) were male and 73 (35.4%) were aged 3 to 7 days. Overall, mean weight was found to be 2.68+0.51 kg. A total of 84 (40.8%) neonates were preterm. Frequency of meningitis was found in 44 (21.4%) neonates. Neonates having low body weight and being preterm were noted to have significant associations (p value < 0.05) with meningitis. Conclusion: Frequency of meningitis in neonates with LOS was high. Low body weight and preterm neonates having LOS were found to have significant association with the presence of meningitis.

Etiology, Clinical Presentation and Incidence of Infectious Meningitis and Encephalitis in Polish Children.

Little is known about the causes and the frequency of meningitis and encephalitis in Poland. We did a retrospective single-center cohort study of children under 18 years old hospitalized with infectious meningitis or encephalitis. Incidence rates were calculated using collected data from patients from the North-East Poland only. A total of 374 children hospitalized between 1 January 2015 and 31 December 2019 were included in the study. A total of 332 (89%) children had meningitis, and 42 (11%) had encephalitis. The etiology of the infection was established in 331 (89%) cases. Enteroviruses accounted for 224 (60%) of all patients. A total of 68 (18%) cases were tick-borne infections. Bacterial pathogens were detected in 26 (7%) children. The median length of hospital stay for children with enteroviral meningitis was 7 days (IQR 7–9), increasing to 11 days (8–13) in those treated with antibiotics. The incidence of meningitis was estimated to be 32.22 (95% CI, 25.33–40.98) per 100,000 and that of encephalitis to be 4.08 (95% CI, 2.07–8.02) per 100,000. By the broad use of molecular diagnostic methods, we managed to identify etiology of the infection in the majority of children. Our data suggest that thorough diagnostics of central nervous system infections are needed to rationalize treatment.

Impact of interventions including vaccination against Neisseria meningitidis on the frequency of meningitis in the African meningitis belt: a scoping review protocol

In the African meningitis belt (region from Senegal to Ethiopia), there are around 30,000 reported cases of meningococcal disease per year. The main aetiological agent is Neisseria meningitidis of serogroup A. Since 2010, vaccination efforts have increased and hundreds of millions of people have been vaccinated. There are indications that the epidemiology of meningococcal disease is changing. This is the protocol of a scoping review, the objective of which is to describe the extent and nature of the research evidence about the impact of vaccination on meningitis frequency. Primary studies and reviews are eligible for inclusion in the review if they assess the impact of interventions that include N. meningitidis vaccination in countries of the African meningitis belt, report meningitis frequencies, and include an element of comparison. The sources of records are electronic databases (MEDLINE, Cochrane register of clinical trials, African Index Medicus, and clinicaltrials.gov), surveillance reports at country level, online resources of large stakeholders involved in vaccination, reference lists of included records, and experts in the field. The search strategy is based on the combination of the condition of interest, the intervention, and the geographical region. The findings of this review will be presented using figures, tables, and thematic narrative synthesis. This review will not produce a pooled estimate of what the impact of vaccination is, but will give insight in how the authors of the included records assessed the impact.

Impact of interventions including vaccination against Neisseria meningitidis on the frequency of meningitis in the African meningitis belt: a scoping review protocol.

In the African meningitis belt (region from Senegal to Ethiopia), there are around 30,000 reported cases of meningococcal disease per year. The main aetiological agent is Neisseria meningitidis of serogroup A. Since 2010, vaccination efforts have increased andhundreds of millions of people have been vaccinated. There are indications that the epidemiology of meningococcal disease is changing. This is the protocol of a scoping review, the objective of which is to describe the extent and nature of the research evidence about the impact of vaccination on meningitis frequency. Primary studies and reviews are eligible for inclusion in the review if they assess the impact of interventions that include N. meningitidis vaccination in countries of the African meningitis belt, report meningitis frequencies, and include an element of comparison. The sources of records are electronic databases (MEDLINE, Cochrane register of clinical trials, African Index Medicus, and clinicaltrials.gov), surveillance reports at country level,online resources of large stakeholders involved in vaccination, reference lists of included records, and experts in the field. The search strategy is based on the combination of the condition of interest, the intervention, and the geographical region. The findings of this review will be presented using figures, tables, and thematic narrative synthesis. This review will not produce a pooled estimate of what the impact of vaccination is, but will give insight in how the authors of the included records assessed the impact.

Intracisternally localized bacterial DNA containing CpG motifs induces meningitis.

Unmethylated CpG motifs are frequently found in bacterial DNA, and have recently been shown to exert immunostimulatory effects on leukocytes. Since bacterial infections in the CNS will lead to local release of prokaryotic DNA, we wanted to investigate whether such an event might trigger meningitis. To that end, we have intracisternally injected mice and rats with bacterial DNA and oligonucleotides containing CpG motifs. Histopathological signs of meningitis were evident within 12 h and lasted for at least 14 days, and were characterized by an influx of monocytic, Mac-3(+) cells and by a lack of T lymphocytes. To study the mechanisms whereby unmethylated CpG DNA gives rise to meningitis, we deleted the monocyte/macrophage population leading to abrogation of brain inflammation. Also, interaction with NF-kappaB using antisense technology led to down-regulation of proinflammatory cytokine production and frequency of meningitis. Furthermore, specific interactions with vascular selectin expression and inhibition of NO synthase led to a significant amelioration of meningitis, altogether indicating that this condition is dependent on macrophages and their products. In contrast, neutrophils, NK cells, T/B lymphocytes, IL-12, and complement system were not instrumental in meningitis triggered by bacterial DNA containing CpG motifs. This study proves that bacterial DNA containing unmethylated CpG motifs induces meningitis, and indicates that this condition is mediated in vivo by activated macrophages.

Haemophilus influenzae infections among hospitalized adult patients.

Relatively few data are available about Haemophilus influenzae (Hi) infection among adults. We studied all adult patients with Hi infection hospitalized between 1988 and 1997 at the University Hospital of Berne. Data were abstracted retrospectively from clinical charts and microbiology records using a standardized questionnaire. 12 invasive and 19 noninvasive Hi infections were observed during the study period. The main clinical manifestations were pneumonia (38.7%), bronchitis (29.0%) and meningitis (12.9%). Most patients (71.8%) had an underlying condition. Lethality was high (22.6%), especially in pneumonia patients (50%). The frequency of meningitis caused by Hi serotype b (Hib) seemed to decrease after 1990 when conjugated vaccines against Hib were introduced. Hi remains an important cause of lower respiratory and invasive disease associated with high lethality among polymorbid adult patients. The frequency of Hib infections may also decrease in adults due to herd immunity induced by universal vaccination of children.

Persistent posttraumatic cerebrospinal fluid leakage

Persistent posttraumatic cerebrospinal fluid (CSF) leakage frequently complicates skull base fractures. Although many CSF leaks will cease without treatment, patients with CSF leaks that persist greater than 24 hours may be at increased risk for meningitis, and many will require surgical intervention. The authors reviewed their 15-year experience with posttraumatic CSF leaks that persisted longer than 24 hours. The authors reviewed the medical records of 51 patients treated between 1984 and 1998 with CSF leaks that persisted for 24 hours or longer after traumatic head injury. In 27 patients (55%) spontaneous resolution of CSF leakage occurred at an average of 5 days posttrauma. In 23 patients (45%) surgery was required to resolve the leakage. Eight patients (16%) with occult CSF leaks presented with recurrent meningitis at an average of 6.5 years posttrauma. Forty-three (84%) patients with CSF leaks sustained a skull fracture, most commonly involving the frontal sinus, whereas parenchymal brain injury or extraaxial hematoma was demonstrated in only 18 patients (35%). Delayed CSF leaks, with an average onset of 13 days posttrauma, were observed in eight patients (16%). Among patients with clinically evident CSF leakage, the frequency of meningitis was 10% with antibiotic prophylaxis, and 21% without antibiotic prophylaxis. Thus, prophylactic antibiotic administration halved the risk of meningitis. A variety of surgical approaches was used, and no significant neurological morbidity occurred. Three (13%) of 23 surgically treated patients required additional surgery to treat continued CSF leakage. A significant proportion of patients with CSF leaks that persist greater than 24 hours will require surgical intervention. Prophylactic antibiotic therapy may be effective in this group of patients. Patients with skull base or frontal sinus fractures should be followed to detect the occurrence of delayed leakage. Surgery-related outcome is excellent.

Association of clinical presentation, laboratory findings, and virus serotypes with the presence of meningitis in hospitalized infants with enterovirus infection.

One hundred eight hospitalized infants with enteroviral infections were studied to determine the association of clinical presentation, laboratory findings, and virus serotypes with the presence of meningitis. Of 108 infants, 55 (51%) had meningitis. Clinical manifestations on admission did not distinguish between infants with and those without meningitis. Echoviruses 30 and 11 and coxsackie virus B were frequently associated with meningitis (34/38; 90%) whereas echoviruses 18, 24, and 25 were not (5/35; 4%). The virus isolation rate was directly proportional to the number of leukocytes in cerebrospinal fluid: 5 of 58 (9%) when up to 9 cells/mm3 were found, 10 of 21 (48%) when 10 to 99/mm3 cells were found, and 25 of 29 (86%) when greater than equal to 100 cells/mm3 were found. Meningitis is often unsuspected in children hospitalized with enterovirus infection. The frequency of meningitis among hospitalized infants is serotype dependent and is most frequently, but not exclusively, found with pleocytosis of the cerebrospinal fluid.

Haemophilus influenzae Meningitis in School-Aged Children

The relative frequency of meningitis caused by Haemophilus influenzae in school-age children was determined by reviewing etiologic diagnoses in children 6 to 15 years old admitted to four hospitals from 1974 to 1978. Sixty-five (45%) of 145 patients had aseptic meningitis and 29 (20%) had bacterial meningitis. Thirty-two (22%) of the patients had received antibiotic therapy before diagnosis, and 19 (13%) could not be classified. Six (21%) of the 29 patients with bacterial meningitis had H influenzae meningitis. Although aseptic disease was the most common type of meningitis, initial antibiotic therapy for presumed bacterial meningitis in school-aged children should include adequate coverage for H influenzae.