Analysis Of Clinical Characteristics And Related Factors For Short-term Prognosis Of Children With Purulent Meningitis

Objective:To summarize clinical characteristics and analyze the related factors for short-term prognostic of children with purulent meningitis,provide important reference for the early diagnosis and treatment of purulent meningitis.Methods:The clinical data of 94 cases with purulent meningitis treated in Children’s Hospital of Shanxi province from September 2013 to September 2016 were retrospectively analyzed to summarize the clinical characteristics.According to the Glasgow outcome scores,all the children were divided into two groups: favorable group(5 points)and adverse group(1~4 points).We eventually filter out statistically different prognostic factors(P<0.05)by comparison and analysis of the information between two groups.The independent risk factors for short-term adverse prognosis of children with purulent meningitis were figured out by the multivariate Logistic regression analysis.Results:1.There were 63 males and 31 females of total 94 cases,with a male to female ratio of 2.03:1.Purulent meningitis occurs mainly in infants and young children(80.86%);and most of the children come from the countryside(62.77%).This disease occurs throughout the year,mainly in autumn.2.The main clinical manifestations of children with purulent meningitis include fever(90.43%),laziness(73.4%),convulsions(50%),headache/dizziness/nausea(47.87%),disturbance of consciousness(29.79%),with positive signs of fontanelle hypertonia(25.53%),positive meningeal irritation sign(39.36%),positive pathological sign(31.91%).Headaches/dizziness/nausea,meningeal irritation often occurs in older children;while laziness and fontanelle hypertonia often in infants.The main pathogens in this study were Streptococcus pneumoniae(35.11%),Enterococcus(18.09%),Coagulase-negative staphylococci(13.83%),Escherichia coli(11.7%).3.Favorable group accounts for 60.64% and 39.36% in adverse group.The result of univariate analysis showed that CRP,CSF-LDH,CSF-LA,CSF-Glu<1.5mmol/L,CSF-Pro>1.0g,convulsions,frequently convulsion after admission,disturbance of consciousness,acute complication,using gamma globulin,Streptococcus pneumoniae as the pathogen,all of these 11 factors were associated with poor prognosis of PM patients.Multivariate Logistic regression analysis showed that CSF-LDH,frequently convulsion after admission and disturbance of consciousness were the three independent risk factors which could affect the prognosis in PM patients.Conclusions:Purulent meningitis in children occurs mainly in males and infants.The primary pathogens were Streptococcus pneumoniae,Enterococcus,Coagulase-negative staphylococci,Escherichia coli,respectively.CSF-LDH,frequently convulsion after admission and disturbance of consciousness were the risk factors which could affect the prognosis in children with PM.Only early identification of risk factors in clinical practice,and giving reasonable treatment timely,can we reduce the incidence of poor prognosis.