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A Clinical Observation on Neonatal Bacterial Meningitis.

Journal of the Korean Pediatric Society 1983;26(9):872-883.
Published online September 30, 1983.
A Clinical Observation on Neonatal Bacterial Meningitis.
Young Ju Lee, Bu Kwun Jung, Soon Ok Byun, Myung Hi Shin, Ji Sub Oh
Department of Pediatrics, Wallace Memorial Baptist Hospital, Busant Korea
신생아 세균성 뇌 막염의 임상적 고찰
이영주, 정부권, 변순옥, 신명희, 오지섭
왈레스기념 침례회병원 소아과
Abstract
A clinical observation was made on 80 cases of neonatal bacterial meningitis who were admitted to the department of Pediatrics at Wallace Memorial Baptist Hospital, Busan, Korea, during a 8 years period between Jan, 1, 1975 and Dec. 31, 1982. 1) There was no significant differences in annual incidence. The incidence of neonatal bacterial meningitis was 0.34% of total admissions in Ped. dept, and 2»2% of total admissions of neonates. 2) Age of onset was mostly in the 1st. week of life(42.5%). The sex ratio of male and female was approximately 1.7:1. 3) The incidence of neonatal bacterial meningitis in our hospital was 1.9 per 1,CCO live births and 4 times higher among premature than full term. 4) There was significant predisposing factors associated with neonatal bacterial meningitis. Of 80 cases/ 44(55%) had perinatal inaterral complications such as preterm birth, prolonged or difficult delivery and premature rupture of membrane, and 36(45%) had neonatal complications such as skin infections, omphalitis urinary tract infections and pneuironia. Of 24 cases who suffered from neonatal bacterial meningitis within the age of 1 week, 27(79.4%) had obstetric complications. 5) Of 80 cases, 29 (36.3%) had positive culture in the CSF, the most comiron organisms being E. coli(34.5%) and Hemolytic streptococci(27.6%). Blood and urine culture yielded as the same organism as CSF culture in 51.7% and 34.5% respectively. 6) The most common presenting symptoms & signs on admissions were nonspecific. The most common findings were a elevated or subncrmal temperature, poor feeding, irritability or listlessness, impaired consciousness, poor Moro reflex, bulging fontanellae, diarrhea, jaundice in order of frequency. 7) Presumpture diagnosis on admission w£S sepsis ard meningitis in 53 cases(€6.3%). 8) Case fetality was 38.8 % which included expired patients in the hopsital(27.5%) and moribund discharge (11.3%), 9) Of the 49 survival cases, 26 were followed-up. Hydrocephalus and cerebral palsy were found in 5 and 3 cases respectively. 10) The mortality was related to prematurity, early onset (before the age 1 wk) of the disease, low sugar level( <20mg/dl) in CSF, and leukopenia«5,000/mm8) or leukocytosis (>30,000/mm3). The highest mortality was seen in case of poor Moro reflex, unconsciousness, seizure, increased number of band form(^6%) in peripheral blood, and high protein level(>300 mg/dl) in CSF.
Key Words: Neonatal Bacterial Meningitis.


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