Bacterial meningitis and CSF biochemical changes in children

Parvin taheri

Introduction: Meningitis is an emergency pediatrics condition of which the early and on time diagnosis plays a major role in prevention of pediatrics mortality and complications. Biochemical changes as well Para clinical reports are reliable clues This study has tried to define bacterial meningitis and CSF biochemical changes children.

Methods and materials:This is an experimental prospective study carried out on 3 month to 12 year children.The data were collected by observing patients. files including 40 patients

diagnosed as bacterial meningitis, hospitalized and treated, in Alzahra hospital pediatrics ward from march2001 to march 2003. The subjects were selected by convenient sampling.

There were two groups as group A including 20 meningitis patients taking oral antibiotics such as Amoxicillin,Ampicillin,

Erythromycin over 24hour. before referring to hospital and groupB including 20 meningitis patients without taking any antibiotics. There were total of 40 samples 25 boys and 15 girls. Just after hospitization the first LP had: been carried out for all subjests and cell culture, sugar and protein all had been checked. Then, the subjects were compared.

Results:The findings showed CSF culture negative in all 25 samples in

group A while there were biochemical changes suggesting bacterial meningitis in CSF of the subjects but in group B in which all samples had not taken antibiotics, there were 13 cases (60%) of positive CSF culture regarding microorganisms as

Meningo-coccus, Streptococcus and Escherichia coli. The number of cell in the first group, taking antibiotics was between 120 to 3170 with mononuclear domination while that was in the second group, not talking any antibiotics, as220 to 3910 with polymorph Nucleons domination. Regarding sugar and protein in CSF, there was no change in both groups. So, taking antibiotics before LP can affect meningitis microorganism and make LP culture negative. According to the findings, oral antibiotics can possibly have no serious effect on CSF cells except for leucocytes, which are fewer. Any delay to send CSF sample to the lab can result in CSF leucocytes changes.

Sending the CSF sample to lab as soon as LP is carried out is suggested.

Discussion and conclusion: Taking oral antibiotics before LP can affect CSF culture results while this has no effect on CSFsugar or protein