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Journal of the Korean Child Neurology Society 2011;19(2):158-164.
Published online August 30, 2011.
Neurologic Complications of Bacterial Meningitis in Children.
Ki Hyun Doo, Hye Won Ryu, Seung Hyo Kim, Seung Soo Kim, Byung Chan Lim, Hui Hwang, Jong Hee Chae, Ki Joong Kim, Yong Seung Hwang
1Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea. prabbit7@snu.ac.kr
2Department of pediatrics, College of Medicine, Jeju National University, Jeju, Korea.
3Department of Pediatrics, College of Medicine, Soonchunhyang University, Cheonan, Korea.
Abstract
PURPOSE
This study was performed to investigate clinical findings of acute neurologic complications and risk factors for chronic neurologic complications of bacterial meningitis in children. METHODS: Pediatric patients with community acquired bacterial meningitis diagnosed at Seoul National University Children's Hospital and Bundang Seoul National University Hospital were included. We investigated the relative frequency of neurologic complications and distribution of causative organisms. Chronic neurologic complication was defined as persistent neurologic deficit including recurrent seizures 6 months from the diagnosis. Multiple logistic regression analysis was used to identify risk factors for epilepsy and motor deficits, which were the most frequently reported chronic neurologic complications. RESULTS: A total of 90 cases were included in the study. Thirteen cases with less than 6 months follow-up duration were excluded from the analysis of risk factors for chronic neurologic complications. The mean age at diagnosis was 15.6 months. Streptococcus agalactiae was the most common pathogen accounting for 27 cases, followed by Streptococcus pneumoniae (19 cases), Hemophilus influenzae type b (13 cases), and Neisseria meningitidis (12 cases). Acute neurologic complications were found in 28 cases (31%): cerebral infarction in 16 cases, subdural effusion in 15 cases, and hydrocephalus in 9 cases. Chronic neurologic complications were found in 41 (53%) cases: epilepsy in 28 cases, motor deficit in 16 cases, hearing loss in 6 cases, and cognitive impairment in 4 cases. Cerebral infarction and S. pneumoniae infection were identified as risk factors for epilepsy. Cerebral infarction was a unique risk factor for motor deficit. CONCLUSION: Cerebral infarction is the important risk factor for the development of chronic neurologic complications including epilepsy and motor deficit in pediatric patients with bacterial meningitis.
Key Words: Bacterial meningitis complication, Streptococcus agalactiae, Streptococcus pneumoniae, Hemophilus influenzae type b, Neisseria meningitidis


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