The sequelae of Hemophilus influenzae meningitis in school-age children

Article Abstract:

Prompt treatment and modern antibiotics have greatly reduced the mortality rate from Hemophilus influenzae meningitis. While mortality rates have fallen below 10 percent, children who survive this disease may have permanent deficits resulting from brain injury sustained during the acute infection. However, the majority of children will recover uneventfully. It is important to determine what characteristics might distinguish the minority of children who will suffer permanent disability. Possible prognostic factors were studied in 97 school-aged children who were treated for meningitis due to infection with Hemophilus influenzae type b. Each of the subjects in the study had a school-aged sibling with whom they were compared. Almost half the children, 41 of 97, suffered neurologic complications during the acute infection. However, only 14 children suffered any sort of persisting neurological deficit. Sensorineural hearing loss was the most common complication, occurring in 11 children. Two patients developed seizure disorders, and one had hemiplegia and mental retardation. The age at time of infection was related to some behavioral changes; older children were more likely to have behavioral problems. Boys were more likely than girls to display difficulties with adaptive behavior when compared with their siblings. These differences were unrelated to cognitive deficits; although some overall cognitive deficit was observed among the patients compared to the siblings, the difference was so slight as to be of negligible clinical importance. It is not known what mechanisms are involved in meningitis that influence adaptive behavior and manifest differently by the sex of the patient. Meningitis patients of lower socioeconomic status were more likely to have poorer performance on tests of intelligence, lower academic performance, and more difficulties with adaptive behavior. Researchers also found that a lower ratio of glucose in the cerebrospinal fluid compared with the blood glucose during the infection correlated with a greater likelihood of deficits. However, the majority of children recovering from H. influenzae meningitis have a good prognosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Complications and side effects, Pediatric diseases, Central nervous system, Hemophilus influenzae, Haemophilus influenzae, Hemophilus meningitis

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Bacterial meningitis: pathogenesis, pathophysiology, and progress

Article Abstract:

Bacterial meningitis occurs when bacteria infect the cerebrospinal fluid (CSF). Types of bacteria that often cause meningitis include Streptococcus pneumoniae, Haemophilus influenzae and Escherichia coli. To infect the CSF, bacteria must avoid the defense mechanisms of the immune system until they cross the blood-barrier into the central nervous system. Patients with bacterial meningitis experience an inflammatory reaction that is caused by components of the bacterial cell wall. During an inflammatory reaction, the body releases cells called cytokines to mediate the body's immune response. Inflammation can cause a breakdown of the blood-brain barrier and increase intracranial pressure. Treatment with corticosteroid drugs may reduce the inflammatory reaction in patients with bacterial meningitis. Patients should be treated simultaneously with antibiotics to kill the bacteria causing the infection.

Development and progression, Bacterial infections

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