Diagnosis, initial management, and prevention of meningitis david m. The outermost layer, the dura mater, is a tough, inelastic, connective tissue layer that sheaths the brain and spinal cord and terminates caudally at the first coccygeal vertebra. Bacterial meningitis is a severe infectious disease of the mem. Clinical features alone cannot determine whether meningitis. Pdf meningitis dd pediatria connie vilchez academia. Epidemic and nonepidemic events included in the analysis. Bacterial meningitis is a potentially catastrophic infectious disease associated with substantial mortality and a risk of permanent disability in survivors. Pdf on jun 1, 2014, maria teresa rosanova and others published meningitis find, read and cite all the research you need on researchgate.
One of them developed brain abscesses and another one died. Predicting outcome of childhood bacterial meningitis with. In the past decades the epidemiology and treatment strategies for communityacquired bacterial meningitis have significantly changed. The clinical criteria must be checked and laboratory aids used in the way to obtain a precise diagnosis. Report for the who meningitis guideline revision may 2014.
Listeria monocytogenes in immunocompromised patients. In general, meningitis due to bacteria bacterial meningitis is more severe than meningitis caused by viruses viral meningitis. Hernan rowensztein clinica pediatrica hospital garrahan revisores. Over the years 200920, we conducted a prospective study within a network established by the italian society of pediatrics to describe the inhospital management of children hospitalized for acute bacterial meningitis in 19 italian hospitals with pediatric wards.
Background the rate of bacterial meningitis declined by 55% in the united states in the early 1990s, when the haemophilus influenzae type b hib conjugate vaccine meningitis pediatria pdf. Meningitis bacteriana aguda revista medica clinica las condes. Bacterial meningitis is a severe infectious disease of the membranes lining the brain resulting in a high mortality and morbidity throughout the world. Bamberger, md, university of missourikansas city school of medicine, kansas city, missouri a cute meningitis is a medical emer. Smoking, secondhand smoke and crowded living conditions also increase the risk for some kinds of.
Clinical and paraclinical characteristics of bacterial. We present the evolution and outcome of four cases of c. Pdf on jun 1, 2014, maria teresa rosanova and others published meningitis find. More common manifestation in children than adults jenkins h, et al. Pneumococcal meningitis and bacteremia pose a significant disease burden in latin america and the caribbean lac. Meningitis parte 1 fisiopatologia, clinica y tratamiento. Jun 25, 2014 this feature is not available right now.
The clinic is useful, being very frequent the presence of meningeal signs. Clinical practice guideline summary clinical practice guidelines for the acute management of infants and children with bacterial meningitis. Meningitis viral meningitis should be excluded from. Even with appropriate treatment, morbidity and mortality can be substantial.
Pediatric drtb meningitis is an underappreciated problem estimated 33,00 incident cases of childhood mdrtb annually as many as % of pediatric cases present with meningitis. There were 1 patients diagnosed with proven meningitis n 63 or suspected meningitis n 50 presented at median 19 days of age, with 63 patients 56% presenting a. Meningitis is usually caused by a bacterial or viral infection that invades the cerebral spinal fluid csf. Cerebral spinal fluid csf is the fluid within the open spaces of the brain that protect and cushion the brain and spinal cord. Epidemiology of pediatric pneumococcal meningitis and. Although the pathogenesis of bacterial meningitis is not completely understood, knowledge of bacterial invasion and entry into the cns is improving. Seizures in a multicenter pneumococcal meningitis surveillance study. Meningitis occurs in people of all ages, but it is more common in children and people over 65. Hospitales hospital ptjptj frecuencia porcentaje porcentaje valido porcentaje acumulado validos h. Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges.
Clinical features are poor discriminators for meningitis, so urgent investigations, starting with lumbar puncture, are key. Enterovirus and parechovirus meningitis in infants younger than 90 days old in the uk and republic of ireland. Dec 15, 2010 acute meningitis is a medical emergency with a potential for high morbidity and mortality. All events occurred in countries of the meningitis belt between 2002 2014. Risk factors associated with the outcomes of pediatric. Diagnosis, initial management, and prevention of meningitis. Most patients do not need brain imaging before lumbar puncture. Analysis of the risk associated with the causative organism of bacterial meningitis was difficult, because most studies included patients with laboratory and clinical findings suggestive of meningitis, but lacked isolation of the etiologic agent using either microbiological or molecular tests. They are frequent and most often benign, but underdiagnosed due to the limited technical platforms of laboratories. Clinical infectious diseases, volume 39, issue 9, 1 november 2004, pages 12671284. The severity of a childs symptoms and prognosis depend on the specific organism that is causing the meningitis. Article pubreader pdf 821k citation select item 3726635 18. Sepsis and meningitis caused by pasteurella multocida and ec.
Meningitis bacteriana pediatria meningitis inflamacion. Most children with viral meningitis recover completely. Over the past several decades, the incidence of bacterial meningitis in children has decreased but there remains a significant burden of disease in adults, with a mortality of up to 30%. Listeria meningitis ampicilina o amoxicilina 2 g cada 4 horas gentamicina 1. Some children with meningitis may have longterm problems, but this depends on the cause of the infection and the age of the child. Neonatal bacterial meningitis most frequently results from the bacteremia that occurs with neonatal sepsis. Inhospital management of children with bacterial meningitis. The bacterial meningitis score bms has been studied and validated to predict patients at very low risk of bacterial meningitis versus aseptic meningitis, as long as none of the following are present. Meningitis is an inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges willey et al 2014. Meningitis american academy of pediatrics textbook of. Csf protein 80mgdl, positive csf gram stain, peripheral absolute neutrophil count.
Citrobacter koseri is a rare cause of neonatal meningitis with predisposal for brain abscesses, and therefore responsible for high mortality and serious neurologic sequelae in this age group. The epidemiology, management, and outcomes of bacterial. Bacterial meningitis completely recover on their own within 7 to 10 days. You get it when a virus enters the body through the nose or mouth and travels. Meningitis may develop in response to a number of causes, usually bacteria or viruses, but meningitis can also be caused by physical injury, cancer or the use of certain drugs. Bacterial meningitis is life threatening, and must be distinguished from the more common aseptic viral. First, the introduction of conjugate vaccines in europe resulted in the virtual disappearance of. Rn vivos meningitis clinical practice guideline local protocols are in place in all hospitals and facilities likely to be required to assess or manage paediatric patients with bacterial meningitis ensure that all staff treating paediatric patients are educated in the use of the locally developed paediatric protocols. The value of quantitatively measuring the serum level of creactive protein crp to distinguish viral versus bacterial meningitis bm of childhood was shown 3 decades ago.
Neonatal bacterial meningitis pediatrics msd manual. A total of 22 epidemic events met the inclusion criteria. Viral meningitis is the most common form of meningitis in the uk, but bacterial meningitis continues to be important, with a high mortality. If it were to perform as well as in the acute osteoarticular infections, 3, 4 we would gain a simple, fairly cheap and rapid. Neonatal bacterial meningitis may also result from scalp lesions, particularly when developmental defects lead to communication between the skin surface and the subarachnoid space, which predisposes to. Pediatric aseptic meningitis is an inflammation of the meninges caused mainly by nonbacterial organisms, specific agents, or other disease processes. The severity of a childs symptoms and prognosis depend on. It is essential for clinicians to recognize the clinical signs and symptoms of meningitis and understand its management and prevention.
The meninges of the central nervous system cns include 3 membranes that support, protect, and nourish the brain and spinal cord. Enteroviral meningitis at a pediatric hospital in dakar senegal. Additionally, people with weak immune systems are more at risk for meningitis. Enteroviral meningitis at a pediatric hospital in dakar senegal author. Shukla b, aguilera ea, salazar l, wootton sh, kaewpoowat q, hasbun r. Epidemiology of bacterial meningitis in the usa from 1997 to 2010. Bacterial meningitis is a severe, lifethreatening infection of the central nervous system that requires immediate medical attention. Group b streptococcus, enteric gram negatives in young infants. Lp is recommended before antibiotics for most cases. The cases show the bacterias propensity for serious. In deutschland wurden im jahr 2014 275 falle 59, in osterreich 2014. Aseptic meningitis including viral meningitis is the most common infection of the central nervous system cns in the pediatric population, occurring most frequently in children younger than 1. There are reports of neonatal sepsis and meningitis caused by p.