Clinical Analysis Of Purulent Meningitis In Preterm And Term Infants

Objective:To comparatively study the risk factors,clinical symptoms,and auxiliary examinations of purulent meningitis(PM)in preterm infants and term infants,so as to provide a basis for timely clinical diagnosis and treatment.Methods:From January 2016 to December 2019,148 neonates diagnosed with purulent meningitis in the neonatal department of the First Hospital of Jilin University,were collected and divided into premature infants and term infants according to gestational age.The clinical data of newborns,including general information,perinatal status of pregnant women,clinical manifestations,and auxiliary examinations,was compared retrospectively.Finding the similarities and differences between purulent meningitis in preterm infants and term infants is convenient for early detection and treatment.Results:(1)General condition for onset: Compared with the full-term infant group,the difference between the two groups was statistically significant(P <0.05).Include: Premature infants have more common male infants in PM,the age of onset is earlier,and the number of hospitalization days is more Long;mother age> 30 years,pregnancy hypertension syndrome and premature rupture of membranes were higher than PM in term infants;incidence of septicemia is higher than PM in term infants.(2)The clinical manifestations and signs of neonatal PM are atypical,with fever(100 cases,67.6%),poor mental and response(91 cases,61.5%),decreased muscle tone(78 cases,52.7%),and skin color changes(74 cases,50%),poor milk intake(60 cases,40.5)were the main manifestations.Changes in skin color,shortness of breath,apnea and decreased muscle tone were more common in preterm infants than in term infants,fever and seizures were more common in term infants than in preterm infants,the difference was statistically significant(P<0.05).(3)Auxiliary examination: ?There was no significant difference between the two groups in white blood cell count,neutrophil ratio and absolute values(P>0.05);platelet levels in the preterm infant group were lower than in term infants,and CRP levels in term infants were higher than in preterm infants.The difference between the two groups was statistically significant(P<0.05).?CSF white blood cell levels increased and glucose levels decreased,there was no significant difference between the two groups(P>0.05);CSF protein levels were higher in the preterm infant group than in term infants,and the difference was statistically significant(P <0.05);?CSF culture positive rate was 8.1%,and there was no statistically significant difference between the two groups(P>0.05);The positive rate of blood culture was 43.2%,and the positive rate of blood culture was statistically different between the two groups(P<0.05).? There was no significant difference in the MRI manifestations of the heads of the two groups of children(P>0.05).Cerebral color Doppler ultrasound showed that cerebral hemorrhage was more common in the preterm infant group,and pia mater echo enhancement was more common in the term infant group.The difference between the two groups was statistically significant(P<0.05).(4)Prognosis: Patients with cerebrospinal fluid leukocytes and proteins increased significantly,and glucose decreased significantly,more likely to develop comorbidities.Conclusions:(1)The clinical manifestations of PM in premature infants are more common in skin color changes,shortness of breath,apnea,and decreased muscle tone.PMs in term infants are more common in fever and convulsions.(2)CRP was not significantly increased in preterm infants with PM,platelet count was lower than that in term infants.(3)Neonatal purulent meningitis has a low CSF culture positive rate,and the PM cerebrospinal fluid protein level is higher in preterm infants.(4).Cerebrospinal fluid leukocytes,proteins significantly increased,glucose significantly reduced those who are more likely to develop comorbidities.