PRESENTING FEATURES OF BACTERIAL-MENINGITIS IN YOUNG INFANTS

More guidance is required in the management of acutely ill, febrile yo ung infants. Of 94 young infants undergoing lumbar puncture (LP) as pa rt of their management, 26 of the 60 (43.3%) presenting with seizures and fever and six of the 34 (17.7%) without seizures had bacterial men ingitis (BM) (relative risk (95% confidence interval) = 2.46 (1.12, 5. 37), p = 0.012). Except for the presence of a bulging fontanelle and f ocal seizures, no other presenting signs or symptoms were significantl y associated with BM; seven of the 26 infants with BM who presented wi th seizures and two of the six without seizures lacked a bulging fonta nelle. Overall, the ratio of BM to other illnesses was 1:1.94; of thos e with BM, 13 of the 32 (40.6%) had co-existing acute respiratory infe ctions and four of the 32 (12.5%) had asexual malaria parasitaemia. Se izures with fever are an important presenting feature of BM in young i nfants and a screening LP should be considered mandatory to confirm or exclude BM in febrile young infants with seizures, unless certain con traindications apply.