Haemophilus influenzae type b still remains a leading cause of meningitis among unvaccinated children - A prospective CSF analysis study

A prospective, hospital-based cerebrospinal fluid (CSF) analysis study was undertaken in 65 children who had diagnostic lumbar puncture on admission f or suspected central nervous system infections. Twenty-three children were clinically diagnosed to have had sepsis and/or meningitis. CSF bacterial cu lture grew Haemophilus influenzae type b (Hib) in four cases and Streptococ cus pneumonia (SP) was cultured in another child. Bacterial antigen was det ected in 13 other CSF specimens and the pathogens were Hib (n = 9), SP (n = 3) and Group B Streptococcus (n = 1). No etiologic cause was identified to explain the abnormal CSP pleocytosis and biochemistry in the remaining fiv e cases. In contrast, the CSF analysis was normal in 42 other children with probable viral and non-infectious neurological condition, mostly febrile c onvulsions. The overall frequency rate for all types of meningitis and espe cially for Hib meningitis were 43 and 31 cases per 100 000 children < 5 yea rs of age, respectively. These findings support our earlier observations th at Hib meningitis still remains the leading cause of childhood meningitis i n our region. Also it reaffirms the observation that bacterial meningitis m ay often be under-reported if CSF positive culture alone is considered for the diagnosis.