Clinical Profile of Bacterial Meningitis in Children and Comparative Inter-Alia Analysis of Various Microbiological Tests

Acute Bacterial meningitis is life-threatening and neurologically debilitating infectious disease. We studied the clinical profile,organisms involved in bacterial meningitis in children and compared tests on Cerebrospinal Fluid (CSF) Latex Agglutination Test (LAT), Polymerase Chain Reaction (PCR), gram stain (conventional), cyto-tek centrifuge cytospin gram stain to culture which is the gold standard .Methods: Ours was a observational cross- sectional study (age range 3 to 12 years) conducted in a tertiary care hospital, New delhi, India for one year. Total of 101 patients were enrolled and divided in 3 age groups viz <1year, 1-5years, >5years. Fever was the most common presenting symptom in all groups (84.2%). Refusal to feed, headache, altered sensorium, vomiting, blurring of vision were significantly associated with bacterial meningitis in all age groups. Cranial nerve palsies and neck rigidity were significantly higher in older children. Age<5years, low socioeconomic status, overcrowding and smoke exposure were identified as risk factors for meningitis. 8 children died within 48 hours of admission in our study the rest had a normal recovery. CSF culture was positive in 35.6% cases with streptococcus pneumoniae being the most common organism. PCR performed best for the diagnosis of meningitis but it has its limitations. Cytospin gram stain showed positivity in 65% cases which much higher compared to conventional gram stain. Cytospin gram stain was a viable low-cost alternative for early diagnosis of meningitis in low income countries like ours.

Author(s):

Rohan Halder,  Aggarwal, Deepthi Nair, Richa Malik

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