소아의 급성화농성 뇌막염의 임상적 고찰

Abstract

Ninety one cases of acute bacterial meningitis. diagnosed during the period of 1977~1982, at pediatric ward of Seoul National University Hospital, were studied. The following results were obtained. 1) Among the total 91 cases, 62 cases (68. 1%) were male and 29 cases (31. 9%) were female. The sex ratio was approximately 2.1 : 1. 2) The highest incidence was showed in the 1st year of life. Most of cases (74.7%) were under 5 year of age. 3) SeasonI incidence was highest in spring and autumn (esp, in May and November). 4) On admission, the most frequent symptom was fever (8S.7%), and followed by vomiting (68.1%), convulsion (59.3%), and headache (57.1%). And the most frequent physical sign was neck stiffness (60.4%), and followed by Kcrnig's sign (38.3%), Brudzinski's sign(29.7%), and buldging fontanel (26.4%). 5) On admission, leukocytosis (WIlC counts over 10,000/mm') on peripheral blood smear was showed in 74 cases (80,.3%). 5) CSF findings revealed increased WBC coun t (over SOO/mm"; 67.0%), increased protein level (over 100mg/dl ; 64.89,,), and decreased sugar level (below 40mg/dl ; 61. 5%). 7) Causative organism were isolated from CSF culture of 37 cases(40.7%). The most common organism was N. menigitidis 01 cases), and followed by H. influenza (8 cases), Pneumococcus (7 cases), S. aureus (3 cases), E. coli (:l cases), P. aeruginosa o case), P. mirabilis 0 case), S. typi (1 case), and Streptococcus 0 case). 8) On admission, 77 cases(84.7%) had a history of preexisting illness or associated disease and URI was most frequent. 9) As the results of treatment, S4 cases (59.3%) were improved or recovered, 9 cases (9.996) expired, 23 cases (25.3%) remained with sequelae, and 5 cases (5.5%) were discharged due to aggravation of symptoms or poor economical problem. 10) The most common sequelae was hydrocephalus 02 cases), and followed by subdural effusion (6 cases), brain abscess (4 Cases), and ventriculitis(4 cases). 11) Among 20 cases having performed the cranial C-T, hydrocephalus 02 cases) was most common.