Acute meningoencephalitis in hospitalised children in southern Bangladesh.
2012
Background: Acute meningoencephalitis is an important cause of
morbidity and mortality around the globe. The objective of this study
was to examine the distribution of acute meningoencephalitis and its
aetiological agents among children admitted to a tertiary hospital in
southern Bangladesh. Methods: This prospective study was carried out in
Khulna Medical College Hospital from 2007 to 2009. All of the admitted
children between 1 month and 12 years of age were enrolled over a
2-year period if they met the inclusion criteria of having an acute
onset of fever (≤ 14 days) and any of the following 3 signs: neck
stiffness, convulsion, or altered mental status. Cerebrospinal fluid
(CSF) was collected within hours and sent to the laboratory for
cytological and biochemical analyses. CSF was examined by Gram staining
and a latex agglutination test to detect common bacteria. Serum and CSF
were also tested for Japanese encephalitis virus antibodies. Results: A
total of 140 children were included in the study, which accounted for
2.5% of admissions between 2007 and 2009. The number of acute
meningoencephalitis cases was relatively higher (37.9%) during the
monsoon season. The CSF report revealed a pyogenic form in 24 (18.5%)
and a viral form in 13 (10.0%) cases. Altered mental status was
significantly less frequent (P < 0.001) in cases of pyogenic
meningoencephalitis (62.5%) than in cases of non-pyogenic
meningoencephalitis (93.4%). Bacterial causes were identified in 11
(8.5%) children; the causative agents included Streptococcus pneumoniae
(n = 8), Neisseria meningitides (n = 2), and Haemophilus influenzae
(n = 1). Three (2.3%) patients were positive for Japanese
encephalitis virus. Conclusion:S. pneumoniae was the most common
bacteria causing acute meningoencephalitis among the study subjects,
and Japanese encephalitis virus was present in few patients.
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