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2017, Number 3

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Gac Med Mex 2017; 153 (3)

Factores de riesgo asociados al desarrollo de complicaciones neurológicas tempranas en meningitis purulenta

Espinoza-Oliva MM, Rizo-Santos DB, Díaz-Peña R, Ortega-Cortés R, Barrera LJC

Language: Spanish
References: 23
Page: 313-320
PDF size: 110.13 Kb.


ABSTRACT

Objective: To determine the risk factors associated with the development of early neurological complications in purulent meningitis in a pediatric population. Methods: This was a case-control study including 78 children aged one month to 16 years with purulent meningitis divided into two groups: cases, with early neurological complications (defined as those presenting ‹ 72 hours from initiation of clinical manifestation), and controls, without early neurological complications. Clinical, serum laboratory, and cerebrospinal fluid (CSF). Results: Seventy-eight patients were included: cases, n = 33, and controls, n = 45. Masculine gender, 19 (57%) vs. feminine gender, 28 (62%) (p = 0.679). Median age in months, 36 months (range, 1-180) vs. 12 months (range, 1-168) (p = 0.377). Factors associated with neurological complications: convulsive crises on admission, p = 0.038, OR, 2.65 (range, 1.04-6.74); meningeal signs, p = 0.032, OR, 2.73 (range, 1.07-6.96); alteration of the alert state, p = 0.003, OR, 13.0 (range, 1.64-105.3); orotracheal intubation, p = 0.000, OR, 14.47 (range, 4.76-44.01); neurological deterioration, p = 0.000, OR, 9.60 (range, 3.02-30.46); turbid CSF, p = 0.003, OR, 4.20 (range, 1.57-11.20); hypoglycorrhachia, ‹ 30 mg/dl, p = 0.001, OR, 9.2 (range, 3.24-26.06); and positive CSF culture, p = 0.001, OR, 16.5 (range, 1.97-138.1). Conclusions: The factors associated with early neurological complications included convulsive crises on admission, meningeal signs, alteration of the alert state, need for orotracheal intubation, turbid CSF, hypoglycorrhachia, and positive CSF culture.


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