Journal of the Korean Pediatric Society 2003;46(4):345-350.
Published online April 15, 2003.
Prognostic Value of Repeated Cerebrospinal Latex Agglutination Testing in Bacterial Meningitis
Soo Jeong Lee, So Hyun Ahn, Su Jin Cho, Hae Soon Kim, Seung Joo Lee
Department of Pediatrics, Ewha Womans University, College of Medicine, Seoul, Korea
세균성 뇌수막염에서 뇌척수액 Latex 응집 추적검사의 유용성
이수정, 안소현, 조수진, 김혜순, 이승주
이화여자대학교 의과대학 소아과학교실
Correspondence: 
Hae Soon Kim, Email: hyesk@ewha.ac.kr
Abstract
Purpose
: Bacterial meningitis is a serious infection of childhood associated with a significant morbidity and mortality. Repeated cerebrospinal fluid(CSF) examination is a useful prognostic indicator and a delayed sterilization is associated with a higher incidence of neurologic abnormalities. In this study we tried to determine the prognostic value of repeated CSF latex agglutination testing.
Methods
: We retrospectively evaluated 19 patients admitted to Ewha Womans University Mokdong Hospital for bacterial meningitis from January 1997 to June 2002. Bacterial meningitis was confirmed by a positive CSF culture and a positive CSF latex agglutination test. Repeated CSF examinations were done at three, seven, 14, 21 and 28 days after antibiotics therapy. Neuroradiologic studies were performed.
Results
: The mean age was 10.6?2.3 months(range; two to 33 months). The male to female ratio was 2.8 : 1. The causative organisms were Haemophilus influenzae type b 57.9%, Group B Streptococcus 21.1%, Streptococcus pneumoniae 15.7% and Escherichia coli 5.3%. Three days after the initiation of antibiotics therapy, repeated CSF latex agglutination tests persisted as positive in nine (47.4%) out of 19 cases, but all CSF cultures became negative. In those cases with negative latex agglutination tests three days after antibiotics therapy, neuroradiologic findings were completely normal. But, in cases with positive latex agglutination tests three days after antibiotics therapy, neuroradiologic abnormalities such as cerebral infarction, encephalomalasia occurred in 44.4%.
Conclusion
: Repeated CSF latex agglutination testing was valuable as a prognostic factor in bacterial meningitis. Neuroradiologic abnormalities may occur in cases with delayed clearance of CSF latex agglutination tests more often than in cases with negative latex agglutination tests three days after antibiotics therapy.
Key Words: Bacterial meningitis, Repeated CSF latex agglutination testing, Late neurologic sequelae


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