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Journal of the Korean Child Neurology Society 2012;20(3):137-143.
Published online September 30, 2012.
Clinical Characteristics of Pediatric Bacterial Meningitis Complicated with Subdural effusion.
Tae Min Um, Yong Seok Kim, Gyu Min Yeon, Sang Ook Nam, Young Mi Kim, Yun Jin Lee
Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea. jinnyeye@hanmail.net
Abstract
PURPOSE
Authors aim to examine the clinical characteristics and relevant factors of the bacterial meningitis with the complication of subdural effusion. METHODS: We identified the 63 children with bacterial meningitis from 2006 to 2011. Thirteen children (group A) had a complication of subdural effusion during the treatment and 50 children (group B) did not. We reviewed their medical records retrospectively regarding demographic profiles, clinical features and laboratory findings. RESULTS: The mean age was younger in group A than in group B (4.9+/-10.1 vs 27.2+/-46.5 months, P=0.046). Of the initial symptoms, fever was the most frequent symptom, while seizures (30.8% vs 8.0%, P=0.028) and lethargy (38.5% vs 16.0%, P=0.070) were more common in group A. Since the antibiotics medication, the duration of vomiting (2.5+/-1.5 vs 1.1+/- 0.3 days, P=0.003) and irritability (2.5+/-1.5 vs 1.1+/-0.3 days, P=0.034) was longer in group A. Initial laboratory findings were significantly different between two groups with elevation of CRP (9.4+/-8.6 vs 4.1+/-6.6 mg/dL, P=0.010), CSF neutrophil ratio (71.2+/-16.4 vs 54.1+/-33.4%, P=0.041), and CSF protein (260.2+/-192.5 vs 119.9+/-148.5 mg/dL, P=0.003) in group A. Follow-up examination showed that CRP (9.3+/-10.4 vs 2.7+/-5.5 mg/dL, P=0.011), CSF cell count (670.6+/-1,014.0 vs 123.5+/-243.8 /mm3, P=0.006), and CSF protein (211.5+/-148.3 vs 82.1+/-85.8 mg/dL, P=0.002) were significantly higher in group A. CONCLUSION: Some significantly different results were shown in the comparison of initial symptoms and their durations and laboratory findings between the patients with subdural effusion following bacterial meningitis and those without subdural effusion.
Key Words: Bacterial meningitis, Subdural effusion, Child, Infant


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