Meningitis without a petechial rash in children in the Hib vaccine era
| Autor: | K. Nye, N. Makwana, F.A.I. Riordan |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Microbiology (medical)
Male Pediatrics medicine.medical_specialty Haemophilus Infections Adolescent medicine.drug_class Antibiotics Anti-Inflammatory Agents medicine.disease_cause Polymerase Chain Reaction Dexamethasone Meningitis Bacterial medicine Viral meningitis Enterovirus Infections Humans Child Bacterial Capsules Purpura Cerebrospinal Fluid Enterovirus Haemophilus Vaccines business.industry Polysaccharides Bacterial Infant Newborn Infant Petechial rash medicine.disease Rash Haemophilus influenzae Meningitis Viral Infectious Diseases Hib vaccine Child Preschool Immunology Female medicine.symptom business Meningitis medicine.drug |
| Zdroj: | The Journal of infection. 49(4) |
| ISSN: | 0163-4453 |
| Popis: | Aims. (1) To determine the causes of meningitis in children immunized with Hib vaccine, presenting without a non-blanching rash; (2) to review the use of dexamethasone in this group. Method. Retrospective review of all children with more then 10 white cells/mm 3 in their cerebrospinal fluid (CSF), admitted between January 1998 and August 2002. Children were excluded if they had a non-blanching rash on admission or if their discharge diagnosis was not meningitis. Local guidelines recommended dexamethasone to be given before antibiotics for children with meningitis and no rash. Results. One hundred and eight children were identified. Causes of proven meningitis were: viral 41 (enterovirus 40), bacterial 22. CSF culture or PCR was the only diagnostic test in 31 children. Dexamethasone was given to 16 children. Length of admission was shorter in children with viral compared with bacterial meningitis (4 vs 8 days; P Summary. Viral meningitis is the commonest cause of meningitis without rash. Enteroviral PCR was the most useful test and needs to be widely available. Confirmation of enteroviral meningitis allowed early discharge. Few children were given dexamethasone, but only 5/108 may have benefited. Conclusions. The most common cause of meningitis without a rash in British children is enterovirus. The use of dexamethasone in children with meningitis without a rash should be reconsidered or, at least, individualised. |
| Databáze: | OpenAIRE |
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