PROGNOSTIC FACTORS IN CHILDHOOD BACTERIAL-MENINGITIS

The purpose of this study was to identify possible risk factors associ ated with a poor prognosis in childhood bacterial meningitis. We also analysed the influence of duration of symptoms and prehospital antibio tic therapy on outcome. Ninety-two children aged 1 month to 13.8 years were included, of whom 4 died (4.3%) and 14 (15.2%) experienced perma nent neurological sequelae. Hearing impairment was the most frequent s equela and was strongly associated with the length of history. Multipl e logistic regression revealed duration of symptoms > 48 h, pre-hospit al seizures, peripheral vasoconstriction, < 1000 x 10(6)/l leucocytes in cerebrospinal fluid and temperature less than or equal to 38.0 degr ees C on admission as risk factors independently associated with later death or sequelae. There was no association between pre-hospital oral or parenteral antibiotic therapy and outcome. These risk factors may be of value in selecting patients for more intensive therapy and in id entifying possible candidates for new treatment strategies.