Table 1

 Clinical details of four children with acute bacterial meningitis presenting as convulsive status epilepticus with fever

Clinical featuresChild 1Child 2Child 3Child 4
PMH, past medical history; VP, ventriculo-peritoneal.
Age (months)39.51526
GenderMMFF
PMHHealthyEx-premature Cerebral palsy VP shunt in situ HydrocephalusHealthyHealthy
Preceding symptomsIrritable hours beforeIntermittent pyrexia × 1/52Intermittent pyrexia × 1/7Nil
Temperature38.2°C38.1°C38.8°C39.1°C
Seizure
    Focal featuresNoYesYesNo
    CharacteristicsContinuousIntermittentContinuousContinuous
    TypeTonic-clonicTonicTonic-clonicTonic-clonic
    Duration (h)0.5–1>21–21–2
MeningismAbsentAbsentAbsentAbsent
RashNilNilNilNil
WBC (×1012/l)38.419.121.35.1
Neutrophils (×1012/l)28.112.017.21.6
C reactive protein (mg/l)2855227964
Preliminary diagnosisABMInfected VP shuntPFCPFC
Immediate antibioticsYesYesYesNo
OutcomeSevere neurological deficitsDeathDeathDeath
Organism in CSF S pneumoniae S pneumoniae S pneumoniae N meningitidis