On discharge 15 patients (53%) had no sequelae; 8 patients (28%) suffered deafness; 4 (14%) had hemiparesis; 2 (7%) had severe hydrocephalus and 1 patient (3.5%) had mental retardation. Four patients (14%) died.
Pneumococcal meningitis in children. review of 28 cases
 
  Key words
 
 
  
   Meningitis
  
 
 
  
   S
  
 
 
  
   pneumoniae
  
 
 
  
   Deafness
  
 
 
  
   Coma
  
 
 
  
   Children
  
 
Objective
To describe the epidemiological characteristics, clinical features and prognostic indicators of pneumococcal meningitis in children admitted to a children's hospital in Madrid.
Patients and method
We retrospectively studied 28 children with a diagnosis of pneumococcal meningitis based on identification of S. pneumoniae in the blood or cerebrospinal fluid between 1990 and 1999.
None of the children had previous immunological deficit or had received antipneumococ-cal vaccine.
Results
The mean age of patients was 2.7 ± 2.9 years (range: 2 months to 11 years).
Eighty-two percent of the children were younger than 5 years old.
Male to female ratio was 1:1.
The most frequent signs on admission were fever (100%), vomiting (57%), headache and irritability (53%), and shock (10%).
Neurologic findings were lowered level of consciousness in 22 patients (mean Glasgow Coma Scale score 9.9 ± 3.9); seizures in 15 (53%); neck stiffness in 12 patients (42%) and arreactive mydriasis in 9 patients (32%).
Twenty patients (71%) required admission to the intensive care unit.
On discharge 15 patients (53%) had no sequelae; 8 patients (28%) suffered <dis>deafness</dis>; 4 (14%) had <dis>hemiparesis</dis>; 2 (7%) had severe hydrocephalus and 1 patient (3.5%) had <dis>mental retardation</dis>.
Four patients (14%) died.
Findings with the strongest predictive value for death or <dis>deafness</dis> (p > 0.05) were coma and alterations in cranial computer tomography (CT).
Seizures, alterations in electroencephalogram (EEG) and hypogly-corrhachia were also prognostic indicators for <dis>deafness</dis> (p < 0.05).
Conclusions
Meningitis caused by S. pneumoniae is a significant cause of morbidity and mortality in children.
<dis>Deafness</dis> is one of the most common and serious sequelae of pneu-mococcal meningitis.
Sequelae were asociated with coma, alterations in CT scan, seizures and hypoglycorrhachia.
The new, antipneumococcal conjugated vaccine will confer effective prevention from the age of 2 months and will produce a dramatic decrease in the incidence of this serious infection.
Objective
To describe the epidemiological characteristics, clinical features and prognostic indicators of pneumococcal meningitis in children admitted to a children's hospital in Madrid.
Patients and method
We retrospectively studied 28 children with a diagnosis of pneumococcal meningitis based on identification of S. pneumoniae in the blood or cerebrospinal fluid between 1990 and 1999.
None of the children had previous immunological deficit or had received antipneumococ-cal vaccine.
Results
The mean age of patients was 2.7 ± 2.9 years (range: 2 months to 11 years).
Eighty-two percent of the children were younger than 5 years old.
Male to female ratio was 1:1.
The most frequent signs on admission were fever (100%), vomiting (57%), headache and irritability (53%), and shock (10%).
Neurologic findings were lowered level of consciousness in 22 patients (mean Glasgow Coma Scale score 9.9 ± 3.9); seizures in 15 (53%); neck stiffness in 12 patients (42%) and arreactive mydriasis in 9 patients (32%).
Twenty patients (71%) required admission to the intensive care unit.
On discharge 15 patients (53%) had no sequelae; 8 patients (28%) suffered deafness; 4 (14%) had hemiparesis; 2 (7%) had severe hydrocephalus and 1 patient (3.5%) had mental retardation.
Four patients (14%) died.
Findings with the strongest predictive value for death or deafness (p > 0.05) were coma and alterations in cranial computer tomography (CT).
Seizures, alterations in electroencephalogram (EEG) and hypogly-corrhachia were also prognostic indicators for deafness (p < 0.05).
Conclusions
Meningitis caused by S. pneumoniae is a significant cause of morbidity and mortality in children.
Deafness is one of the most common and serious sequelae of pneu-mococcal meningitis.
Sequelae were asociated with coma, alterations in CT scan, seizures and hypoglycorrhachia.
The new, antipneumococcal conjugated vaccine will confer effective prevention from the age of 2 months and will produce a dramatic decrease in the incidence of this serious infection.
On discharge 15 patients (53%) had no sequelae; 8 patients (28%) suffered <dis>deafness</dis>; 4 (14%) had <dis>hemiparesis</dis>; 2 (7%) had severe hydrocephalus and 1 patient (3.5%) had <dis>mental retardation</dis>. Four patients (14%) died.
deafness
DISABILITY
hemiparesis
DISABILITY
mental retardation
DISABILITY