BACTERIAL MENINGITIS IN CHILDREN

Objective: To study the demographic features, yield of gram staining, cerebrospinal fluid culture and etiological pattern of bacterial meningitis in children of 2 months to 12 years.Material and Methods: A hospital based prospective and descriptive study was carried out at the Department of Pediatrics, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar. All those children in the age group between 2 months to 12 years having clinical suspicion of meningitis and cerebrospinal findings suggestive of meningitis i.e. >10xl06WBC/L and/or CSF sugar <40mg% or (<50% of the circulating blood sugar) and/or CSF protein >80mg% were included in the study. Children having history of intake of antibiotic in the last 5 days which can cross the blood brain barrier and children with tuberculous meningitis were excluded.Results: A total of 120 patients (1.7% of the total admissions) were included in the study. Male patients were 69 (57.5%) and female were 51 (42.5%). Out of 120, 47(39.2%) were in the age group of 2 months-1 year, 39 (32.5%) were in the age group of >l-5years and 34 (26.3%) were in the age group of >5-12years. Majority of our children were below 5years i.e. 71.7%. Gram staining was positive in 68(56.7%) cases and negative in 52(43.3%). The CSF cultures were positive in 59(49.2%) cases and negative in 61(50.8%). The three most common pathogens isolated were Streptococcus Pneumoniae 27(22.5%) cases, Neisseriae Meningitides 20(16.7%) cases and Hemophilus influenzae B 11(9.2%) cases.Conclusion: Bacterial meningitis is the major cause of morbidity in children below the age of 5 years. The yield of gram staining and culture though comparable with the national studies but lower than reported internationally. S Pneumoniae, N Meningitides and H Influenzae are the three most common causes of Bacterial Meningitis in our children as reported nationally and internationally.