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- Title
The Etiology, Clinical Characteristics and Treatment Modalities in Children with Meningitis and Encephalitis: A Retrospective Single Center Study in Türkiye.
- Authors
Dağdelen, Erdi Çağrı; Çil, Merve Kılıç; Çelik, Tamer; Celiloğlu, Can; Arslan, İlknur; Tolunay, Orkun; Çelik, Ümit
- Abstract
Objective: Central nervous system infections are diseases with high morbidity and mortality if not treated early and effectively in the childhood. In our study, it was aimed to evaluate the demographic and clinical characteristics, complications and treatment modalities and to determine short-term prognosis in pediatric patients with meningitis and encephalitis. Material and Methods: In this retrospective cross-sectional study; patients aged between one month and 18 years, who were hospitalized in the Department of Pediatrics of Adana City Training and Research Hospital, between October 2017 and May 2021 were included. Results: A total of 70 patients; 38.5% females, 61.5% males were included into the study. When grouped according to their diagnosis, 36 patients were diagnosed with meningitis, seven patients with meningoencephalitis and 27 patients with encephalitis. Mean age of the meningitis patients was 90.9 ± 74.1 months, that of meningoencephalitis patients was 115.4 ± 58.1 months, and that of encephalitis patients was 67.9 ± 54.3 months. Headache, neck pain and vomiting in meningitis patients; altered consciousness in patients with meningoencephalitis and encephalitis; convulsion in encephalitis patients were found to be significantly higher than in other diagnostic groups. CSF culture and multiplex PCR showed the causative agent in 44% (n= 16) of the patients. S. pneumoniae was detected in 43% (n= 7), N. meningitidis in 25% (n= 4), M. tuberculosis in 19% (n= 3) of the patients with bacterial meningitis. Enterovirus was detected in 13% (n= 2) of patients. Brain MRI abnormalities were detected in 52% (n= 14) of encephalitis patients. EEG abnormality was detected in 63% (n= 17) of encephalitis patients. Antiepileptic use was also present in 81% (n= 22) of encephalitis patients. Complications developed in the acute phase during the course of treatment in 17% (n= 6) of meningitis patients. Fifty-two percent (n= 14) of encephalitis patients, 43% (n= 3) of meningoencephalitis patients, and 11% (n= 4) of meningitis patients were discharged with sequelae. Two patients with tuberculous meningitis/meningoencephalitis died. The risk of sequelae was found to be significantly higher in meningoencephalitis and encephalitis patients compared to meningitis patients (p< 0.05). Conclusion: Central nervous system infections are a disease group presenting with fever, nausea and vomiting. In addition to these findings, the disease may progress with neurological findings and may require intensive care follow-up. With an early diagnosis and treatment, satisfactory results can be obtained, especially in patients with encephalitis with a high risk of sequelae.
- Subjects
TURKEY; MENINGITIS treatment; CEREBROSPINAL fluid examination; ENCEPHALITIS diagnosis; TREATMENT of encephalitis; MENINGITIS diagnosis; ENCEPHALITIS; ENTEROVIRUSES; BRAIN; ANTICONVULSANTS; ACADEMIC medical centers; FEVER; NECK pain; ELECTROENCEPHALOGRAPHY; CHILDREN'S hospitals; PEDIATRICS; RETROSPECTIVE studies; MAGNETIC resonance imaging; VOMITING; STREPTOCOCCUS; BACTERIAL meningitis; TREATMENT effectiveness; COMPARATIVE studies; CENTRAL nervous system infections; DESCRIPTIVE statistics; GRAM-negative aerobic bacteria; EARLY intervention (Education); MENINGITIS; COMBINED modality therapy; HEADACHE; CONSCIOUSNESS disorders; SEIZURES (Medicine); POLYMERASE chain reaction; MENINGOENCEPHALITIS; SYMPTOMS; DISEASE complications
- Publication
Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi, 2023, Vol 17, Issue 4, pe234
- ISSN
1307-1068
- Publication type
Article
- DOI
10.5578/ced.20239602