Clinical, epidemiological characteristics and therapeutic management of pediatric meningitis in two institutions of Medellin, Colombia

Introduction: Meningitis is a medical emergency that requires early diagnosis and treatment to avoid complications. Objective: To determine the clinical, epidemiological characteristics and therapeutic management of meningitis in early childhood. Materials and methods: A cross-sectional study, which evaluated children up to six years old with bacterial or aseptic meningitis from 2010 to 2013, was conducted in two centers in Medellin. Clinical, paraclinical and therapeutic characteristics were collected. The qualitative variables were described by absolute and relative frequencies, and the quantitative ones with median and interquartile range. Differences in patient characteristics according to age group were explored, using the Chi-square or Fisher test. Results: From the 56 patients studied, 33 (58.9%) were male; 26 (46.4%) showed bacterial meningitis, 20 (35.7%) aseptic one and 10 (17.9%) indeterminate one; 36 (64.3%) were older than two months, with non-specific clinical manifestations (fever and irritability). Gram-negative microorganisms were mainly isolated in blood cultures and Gram positive in cerebrospinal fluid. The most common antibiotic treatment was third-generation cephalosporins in 13 (65%) children who were less than 2 months and 28 (77.8%) in older ones. Two patients died and six children presented complications. Conclusions: Bacterial meningitis was the most frequent in children under one year old. Combined treatment is ideal to ensure adequate coverage and avoid complications

Características clínicas, epidemiológicas y manejo terapéutico de la meningitis pediátrica en dos instituciones de Medellín, Colombia

Introduction: Meningitis is a medical emergency that requires early diagnosis and treatment to avoid complications. Objective: To determine the clinical, epidemiological characteristics and therapeutic management of meningitis in early childhood. Materials and methods: A cross-sectional study, which evaluated children up to six years old with bacterial or aseptic meningitis from 2010 to 2013, was conducted in two centers in Medellin. Clinical, paraclinical and therapeutic characteristics were collected. The qualitative variables were described by absolute and relative frequencies, and the quantitative ones with median and interquartile range. Differences in patient characteristics according to age group were explored, using the Chi-square or Fisher test. Results: From the 56 patients studied, 33 (58.9%) were male; 26 (46.4%) showed bacterial meningitis, 20 (35.7%) aseptic one and 10 (17.9%) indeterminate one; 36 (64.3%) were older than two months, with non-specific clinical manifestations (fever and irritability). Gram-negative microorganisms were mainly isolated in blood cultures and Gram positive in cerebrospinal fluid. The most common antibiotic treatment was third-generation cephalosporins in 13 (65%) children who were less than 2 months and 28 (77.8%) in older ones. Two patients died and six children presented complications. Conclusions: Bacterial meningitis was the most frequent in children under one year old. Combined treatment is ideal to ensure adequate coverage and avoid complications