Abstract

We undertook this study to determine the relative frequency of meningitis and sepsis in a paediatric intensive care unit (PICU) and to define the clinical features of children with meningitis and sepsis at the time of admission to the PICU.

We reviewed the medical records of 162 patients with sepsis and meningitis, in the PICU, from 2000 to 2007.

Among these patients 93 (57.4%) had meningitis, 125 (77.2%) had sepsis and 78 (48.1%) patients had bacteraemia, 108 patients (66.7%) had no meningeal signs. Ages ranged from 1 month to 14 years (mean 1–5 years); boys 98 (60.5%), girls 64 (39.5%). Temperature at the time of admission was greater than 38°C in 142 (87.7%) patients. Peripheral white cell count was from 200 to 58 000/mm³ (mean 14 164/mm³). Leucocytosis was noted in 64 (41.6%) patients and leucopenia in 35 (22.7%). 113 (69.8%) patients had a lumbar puncture performed. Six had lumbar puncture but were haemorrhagic and those 43 patients who did not have lumbar punctures had diffuse intravascular coagulation. The species of microorganism in 40 patients (24.7%) was meningococcus group B, in 15 patients (9.3%) pneumococcus and in 56 patients (34.6%) no microorganism was found. 113 of the 162 (69.8%) patients received intravenous ceftriaxone. 151 (92.6%) patients recovered and 11 (6.8%) died.

Meningitis and sepsis remain a serious problem in the PICU despite existing guidelines of therapy and prognostic signs at the time of admission to the PICU.