| Abstrakt: |
We studied the outcome of pneumococcal meningitis in 83 children who were admitted to a referral hospital and whosemeningitis was diagnosed between 1970 and 1994. The median age of the children was 8 months. The most frequently isolated capsular serotypes and/or serogroups of Streptococcus pneumoniae were 6, 14, 18, 19, and 23. Twenty-ninechildren (35%) were referred by other hospitals. A mortality rate of 17% (primary referrals, 7%; secondary referrals, 35%) was observed. At discharge,25 survivors(36%) had sequelae: hearing loss(⩾30 dB)in 19%and neurological sequelaein 25%. During admission, the presenceofcoma,respiratorydistress,shock,a cerebrospinal fluid (CSF) protein level of ⩾2.5 gIL, a peripheral white blood cell count of <5 × 109/L, and a serum sodium level of <135 mmollLwere associatedwith mortality. Sequelae were associatedwith the presence of coma and a CSF glucose levelof <0.6 mmollL. Weconcludethat the mortality rate of pneumococcal meningitis is lower among children than among adults. Children often die of neurological sequelae, while adults frequently die of cardiorespiratory failure due to underlying diseases. For children, coma, respiratory distress, and shock during admission were the clinical findings with the strongest predictive value for sequelaeor death. [ABSTRACT FROM PUBLISHER] |
