Childhood acute bacterial meningitis: Risk factors for acute neurological complications and neurological sequelae

Objective: to assess acute neurological complications and neurological sequelae of childhood acute bacterial meningitis in order to determine possible warning signs. methods: this retrospective study evaluated children with acute bacterial meningitis (between 1 month and 14 years of age) admitted between 2003 and 2006. results: of the 44 patients studied,17 (38.6%) had acute neurological complications. seizure was the most frequent (31.8%) complication. patients with acute neurological complications showed a higher frequency of lower neutrophil count (p = 0.03),seizure at admission (p < 0.01),and s. pneumoniae as the etiologic agent (p = 0.01). risk factors for the development of acute neurological complications were s. pneumoniae (odds ratio [or] = 6.4,confidence interval [ci] 1.7-24.7) and neutrophil count < 60% (p < 0.01). of the 35 patients who were followed up,14 had neurological sequelae (40%). behavioral change (22.9%) was the most frequent sequela. seizures at admission (or = 5.6,ci 1.2-25.9),cerebrospinal fluid protein concentration > 200 mg/dl (p < 0.01),and cerebrospinal fluid glucose concentration/glycemia ratio (p < 0.01) were identified as risk variables for sequelae. conclusion: neutrophil count < 60%,seizure at admission,and s. pneumoniae as the etiologic agent were identified as warning signs for acute neurological complications,while protein levels,cerebrospinal fluid glucose concentration/glycemia ratio,and seizure at admission were seen as risk factors for neurological sequelae. copyright © 2011 by sociedade brasileira de pediatria.