| Clinical Studies of Purulent Meningitis in Infants and Children |
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Soon Hee Lee |
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Department of Pediatrics,Yonsei University College of Medicine Seoul, Korea |
| 소아의 화농성 뇌막염에 관한 임상적 고찰 |
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이수희 |
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연세대학교 의과대학 소아과학교실 |
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| Abstract |
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After development of antimicrobial therapy, mortality from acute bacterial meningitis has been reduced dramatically, but still this disease has remained a serious and lifethreatening in fectious disease of childhood or late sequelae in surviving patients. This author made a clinical study of bacterial meningitis in 183 cases occurring in the under 15 age group admitted to the department of Pediatrics at Severance Hospital, Yonsei University from Jan. 1, 1960 to Dec. 31, 1974. 1.Among the 183 cases, 128 cases (69. 9%) were male and 55 cases (30.1%') were female. The sex ratio was approximately 2.3 : 1. 2.Most cases occurred during the spring and winter seasons and the highest incidence was found in the under 5 age group (114 cases, 62%). Also among 29 deaths, 15 cases (52%) who died were under 1 year old. 3.The most frequent symptom was fever (74%) followed by vomiting (61.7%), headache (33.9%), convulsion (31.7%) and unconsciousness (22.4%). And the most frequent physical sign was neck stiffness (43.7%) followed by Kernig’s sign (38.3%), and Brudzinski’s sign
(20.8%). 4.Cerebrospinal fluid examination was seen on direct smear in 72 cases. Among these, 20 cases were Gram(-) diplococci, 17 cases Gram(+) diplococci and 15 cases Gram(+) cocci. In 79 out of 183 cases cultured, the most common organism was pneumococci C19 cases), next common H. influenza (16 cases), followed by Staphylococci (14 cases). 5.Cerebrospinal fluid finding revealed marked increased cell count (500~5, 000/mm3, 41. 0%)and protein (100~500mg%, 67. 8%) and about 75% of the patients revealed less than 40 mg % of sugar level. Peripheral W.B.C. revealed leukocytosis. 6. On admission, 56. 3% of the cases had a history of preexisting illness or associated disease.113 cases improved or recovered during hospitalization C61. 3%) and 29 cases expired (15. 8%). 17 cases remained with sequellae (9.3%). 7. Among 17 cases, the most common sequellae was subdural effusion (7 cases), next hydrocepalus (3 cases) and me ntal retardation (2 cases) in order of frequency.
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