All issues > Volume 34(2); 1991

Original Article

J Korean Pediatr Soc. 1991;34(2):206-216. Published online February 28, 1991.

Clinical studies of meningitis cases in children.

Chun Oh Lee¹, Song Nyeon Choi¹, Yong Wook Kim¹, Ki Bok Kim¹

¹Department of Pediatrics, Kwangju Christian Hospital, Kwangju, Korea

Received: July 12, 1990;  Accepted: October 5, 1990.

Abstract

A clinical studies were carried out on 442 cases who were admitted to the Department of Pediatrics, Kwangju Christian Hospital under impression of meningitis during a 7 year period form January, 1982 to December, 1989. The results are summerized; 1) No yearly fluctuation in incidence for both purulent and aseptic meningitis was noted, but decreasing tendency was clearly seen for tuberculous meningitis. 2) Purulent meningitis affected mostly babies under 1 year of age. Children aged from 5 to 10 years were affected by the aseptic type, whereas tuberculous meningitis affected mostly aged from 1 to 5 years. The male-to-female ratio was 1.9:1 in the purulent, 2.4:1 in the aseptic, 1.5:1 in the tuberculous meningitis. 3) Peak seasonal incidence was seen in spring for the purulent, in summer for the aseptic, while tuberculous meningitis peaked in spring and summer. 4) Common chief complaints were fever, vomiting, headache and convulsion. On physical examina- tion, neck stiffness, Kemig’s sign, Burdzinski’s sign were detected in decreasing frequency. Relatively higher incidence of anorexia, irritability, bulging fontanelle was noted in the purulent, whereas convulsion and mental change were frequently found in tuberculous meningitis. 5) Cerebrospinal fluid examinations at the time of admission revealed that purulent meningitis showed high levels in cell count, in percentage of neutrophils, and in protein concentration, but low level in sugar. While asecptic meningitis was within normal range for the most laboratory findings with low cell count, the tuberculous meningitis ranged between the purulent and the aseptic with moderately elevated findings. 6) Positive culture rate found in the case of prulent meningitis was lower than other reports. Organisms isolated were Pneumococci (9 cases), Hemophilus influenza (7 cases), Neisseria menin- gitidis (6 cases), and so on. 7) The mode of length of hospital stay ranged between 16 to 20 days for the purulent, 11 to 15 days for the aseptic, and over 20 days for the tuberculous meningitis. 8) The cases of aseptic meningitis took better clinical courses, with most patients discharged without any complications or sequelae. Fatal outcome was found in 12.0% of the purulent and in 14. 9% of tuberculous meningitis. Complications and sequelae followed in 13.4% and 35.0%, respectively.

Keywords :Meningitis in infants and children