[The clinico-biological, etiological and therapeutic aspects of acute purulent meningitis in newborn and older infants].

Abstract

Acute purulent meningitis of the newborn and infant still raise difficult diagnosis problems due to the often misleading onset, and require an energetic and early intervention, adapted, as much as possible, to the etiologic aspects. The study reports on 90 cases of acute purulent meningitis in the newborn and infant, admitted to the pediatric ward of the Bistriţa County Hospital, for 6 years (1983-1988). The clinical and biological aspects were various, sometimes blurred by the antibiotic administration. The study of CSF was the only valuable and compulsory parameter for supporting the diagnosis of meningeal infection and its etiology. In 63.3% cases, the meningeal infection was secondary to a primary infectious focus. Living gram-negative bacilli had the most frequent etiology, both in the newborn and in the infant. Meningitis with nonspecific etiology still hold 45.5%, and the most useful therapy in this situation seemed to be ampicillin + gentamicin + Biseptol and ampicillin + chloramphenicol. The age of the newborn and infant, the male sex, the biologic defects, the type and virulence of the etiologic agent were favouring factors in the appearance and severe evolution of the meningeal infection. Mortality was of 18.8% and the early found sequelae 8.8%. The evolution was favourable, when the diagnosis was precocious and the therapeutic intervention was energetic.