https://scholars.lib.ntu.edu.tw/handle/123456789/145735
標題: | Analysis of clinical outcomes in pediatric bacterial meningitis focusing on patients without cerebrospinal fluid pleocytosis | 作者: | Lin, Wen-Li Chi, Hsin Huang, Fu-Yuan Huang, Daniel Tsung-Ning Chiu, Nan-Chang |
關鍵字: | bacterial meningitis;cerebrospinal fluid;children;prognosis | 公開日期: | 2016 | 起(迄)頁: | 723-728 | 來源出版物: | Journal of Microbiology Immunology and Infection | 摘要: | Background: Cerebrospinal fluid (CSF) cell count and biochemical examinations and cultures form the basis for the diagnosis of bacterial meningitis. However, some patients do not have typical findings and are at a higher risk of being missed or having delayed treatment. To better understand the correlation between CSF results and outcomes, we evaluated CSF data focusing on the patients with atypical findings. ;Methods: This study enrolled CSF culture-proven bacterial meningitis patients aged from 1 month to 18 years in a medical center. The patients were divided into "normal" and "abnormal" groups for each laboratory result and in combination. The correlations between the laboratory results and the outcomes were analyzed. ;Results: A total of 175 children with confirmed bacterial meningitis were enrolled. In CSF examinations, 16.2% of patients had normal white blood cell counts, 29.5% had normal glucose levels, 24.5% had normal protein levels, 10.2% had normal results in two items, and 8.6% had normal results in all three items. In logistic regression analysis, a normal CSF leukocyte count and increased CSF protein level were related to poor outcomes. Patients with meningitis caused by Streptococcus pneumoniae and hyponatremia were at a higher risk of mortality and the development of sequelae. ;Conclusions: In children with bacterial meningitis, nontypical CSF findings and, in particular, normal CSF leukocyte count and increased protein level may indicate a worse prognosis. Copyright (C) 2014, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/279955 | DOI: | 10.1016/j.jmii.2014.08.013 |
顯示於: | 臨床醫學研究所 |
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