Risk for Acute Bacterial Meningitis in Children,,, Print E-mail
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Risk for Acute Bacterial Meningitis in Children with Complex Febrile Seizure

Bacterial meningitis is uncommon in children who present with a first complex febrile seizure.


In a retrospective chart review, researchers examined the rate of acute bacterial meningitis (ABM) in 526 otherwise healthy children (age range, 6–60 months) who presented with their first complex febrile seizure (focal seizures, duration >15 minutes, multiple seizures within 24 hours) to a tertiary care pediatric emergency department in Boston between 1995 and 2008.

A total of 156 children (29%) were pretreated with antibiotics. Of 340 patients (65%) who underwent lumbar puncture (LP), 14 (2.7%) had cerebrospinal fluid (CSF) pleocytosis (white blood cell count >7 cells/µL). Three patients (0.9%) were diagnosed with ABM; two had Streptococcus pneumoniae in CSF culture and one, in whom LP was not successful, had S. pneumoniae in blood culture. One patient with ABM was nonresponsive at presentation, another had a bulging fontanelle and nuchal rigidity, and the third patient had two brief generalized seizures within 24 hours. Two patients with ABM presented before the introduction of the conjugate pneumococcal vaccine. Among the 161 (of 186) children who did not undergo LP and returned for follow-up, none had ABM.


Citation(s):

Kimia A et al. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics 2010 Jul; 126:62.

 

 

 

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