All issues > Volume 26(9); 1983

Original Article

J Korean Pediatr Soc. 1983;26(9):872-883. Published online September 30, 1983.

A Clinical Observation on Neonatal Bacterial Meningitis.

Young Ju Lee¹, Bu Kwun Jung¹, Soon Ok Byun¹, Myung Hi Shin¹, Ji Sub Oh¹

¹Department of Pediatrics, Wallace Memorial Baptist Hospital, Busant Korea

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.

Keywords :Neonatal Bacterial Meningitis.