Published in:
01-02-2013 | Original Paper
Early neurologic complications and long-term sequelae of childhood bacterial meningitis in a limited-resource country (Kosovo)
Published in: Child's Nervous System | Issue 2/2013
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Purpose
Since neurologic complications of childhood bacterial meningitis are encountered frequently despite antibiotic treatments, the purpose of this study was to analyze early neurologic complications and long-term sequelae of bacterial meningitis in children in a limited-resource country (Kosovo)
Methods
This study uses a retrospective chart review of children treated for bacterial meningitis in two study periods: 277 treated during years 1997–2002 and 77 children treated during years 2009–2010.
Results
Of the 277 vs 77 children treated for bacterial meningitis, 60 (22 %) vs 33 (43 %) patients developed early neurologic complications, while there were 15 (5.4 %) vs 2 (2.6 %) deaths. The most frequent early neurologic complications were the following: subdural effusions (13 vs 29 %), recurrent seizures (11 vs 8 %), and hydrocephalus (3 vs 3 %). The relative risk (95 % confidence interval) for neurologic complications was the highest in infants (3.56 (2.17–5.92) vs 2.69 (1.62–4.59)) and in cases caused by Haemophilus influenzae 1.94 (1.09–3.18) vs Streptococcus pneumoniae 2.57(1.26–4.47). Long-term sequelae were observed in 10 vs 12 % of children, predominantly in infants. The most frequent long-term sequelae were late seizures 9 vs 1 %, neuropsychological impairment 1 vs 5 %, and deafness 1 vs 3 %.
Conclusions
In both study periods, the most frequent early neurologic complications of childhood bacterial meningitis were subdural effusions. Long-term sequelae were observed in 10 % of children, with late seizures, neuropsychological impairment, and deafness being the most common one. Age prior to 12 months was risk factor for both early neurologic complications and long-term sequelae of bacterial meningitis in children.