Studies on Bacterial Meningitis Caused Due to Hydrocephalus
Meningitis is estimated to kill 164000 children globally each year. According to population based studies, the incidence of acute bacterial meningitis in China ranges from 6.95 to 22.3 cases/100000 children <5 years of age, and acute bacterial meningitis is more common in resource poor settings. The negative consequences of bacterial meningitis in developed countries have been significantly reduced by vaccination strategies, antibiotic treatment, and good quality care facilities. Many developing countries are still facing cases of bacterial meningitis in children, which is attributable to non-implementation of vaccination programs against meningeal pathogens. Although the mortality rate associated with bacterial meningitis is lower than other major causes of childhood disease, it continues to be high, and approximately 50% of children who survive bacterial meningitis develop neurologic complications such as subdural effusions or emphysemas, cerebral abscesses, focal neurologic deficits, hydrocephalus, cerebrovascular abnormalities, altered mental status, and seizures. Accurate monitoring of pathogen specific estimates of bacterial meningitis is challenging in many countries because of the limited availability of laboratory based surveillance and the misuse of antibiotics. Late and insufficient results for cerebrospinal fluid cultures and gram stain make treatment more difficult, particularly in patients with neurologic complications. With the widespread use of medical imaging technology, hydrocephalus caused by bacterial meningitis has recently attracted increasing concern. A meta-analysis of the global and regional risks for disabling squeal from bacterial meningitis found that since 2010 the overall increase in hydrocephalus in children older than 1 month with bacterial meningitis is 7.1%, 4 and hydrocephalus is the main factor of mortality. We conducted a single center study to investigate the clinical features of and risk factors related to hydrocephalus in children with bacterial meningitis, in order to facilitate early identification and accurate evaluation.
Congenital hydrocephalus is a serious condition that can arise from multiple causes. It comprises a diverse group of conditions which result in impaired circulation and absorption of cerebrospinal fluid. The incidence is 0.4–0.8 per 1000 live borns and stillbirths. This condition is caused by mutations in the gene at Xq28 encoding for L1, a neural cell adhesion molecule. In general, recurrence risk for congenital hydrocephalus excluding X-linked hydrocephalus is low; empiric risk figures found in various studies range from <1% to 4%. We stress the importance of additional clinical investigations.
Deepak Kumar Punna*
To read the full article Download Full Article | Visit Full Article
Menu