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Journal of the Korean Child Neurology Society 2013;21(4):241-249.
Published online December 30, 2013.
A Clinical Study of Pediatric Bacterial Meningitis in Daejeon and Chungcheong area : 2006-2010.
Youn Jong Park, Chen Chen Chu, Jon Soo Kim, Seung Soo Kim, Young Chang Kim, Won Seop Kim, Jeesuk Yu, Keon Su Lee, Young Hyuk Lee, Ho Jin Park
1Department of Pediatrics, Eulji University School of Medicine, Daejeon, Korea. pedneuro@eulji.ac.kr
2Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Korea.
3Department of Pediatrics, Chungbuk National University School of Medicine, Cheongju, Korea.
4Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea.
5Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, Korea.
6Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea.
The aim of this study was to investigate the causative organisms, clinical manifestations, and prognosis of pediatric patients with bacterial meningitis in Daejeon and Chungcheong area, occurred from 2006 to 2010. METHODS: We retrospectively reviewed medical records of patients aged between 1 month and 15 years, diagnosed with bacterial meningitis at 8 university or general hospitals in Daejeon and Chungcheong area. The bacterial meningitis was defined by isolation of organism from cerebrospinal fluid(CSF). The data was collected from January 2006 to December 2010, and analyzed including patient's demographics, causative organisms, clinical presentation, laboratory findings and complications. RESULTS: During the 5-year study period, 24 patients were diagnosed with CSF culture-proven bacterial meningitis. The most common causative organism was Streptococcus pneumoniae (S. pneumoniae, 37.5%), and the others were group B streptococcus (GBS, 20.8%), Escherichia coli (E. coli, 16.7%), Neisseria meningitidis (N. meningitidis, 8.3%), Haemophilus influenzae (H. influenzae, 4.2%), respectively. They initially complained of fever (95.8%), vomiting (83.3%), anorexia (45.8%), seizure (29.2%), headache (20.8%). The leukocyte counts exceeding 1,000/mm3 in CSF was observed in 14 patients (58.3%). In 15 patients (62.5%), the glucose concentration in CSF was less than 50 mg/dL, 18 patients showed that the protein concentration in CSF was more than 100 mg/dL. Long-term neurologic sequelae were observed in 4 patients (16.7%) and described as hearing disturbance (2 patients), hemiparesis (1 patient) and endocrine dysfunction (1 patient). Ten patients (41.7%) showed abnormal neuroradiologic findings and the most common abnormalities was subdural effusion (25.0%). CONCLUSION: Compared to the previous study performed between 2001 and 2005, S. pneumonia continued to be the leading cause of the pediatric bacterial meningitis in Daejeon and Chungcheong area. The frequency of pneumococcal meningitis was not decreased, despite of the introduction of conjugated pneumococcal vaccination. On the other hand, H. influenzae meningitis was notably decreased.
Key Words: Bacterial meningitis, Pediatric, Organisms, Streptococcus pneumoniae, Haemophilus influenzae


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