摘要
Aims: In children with convulsive status epilepticus (CSE)with fever, to deter mine the likelihood of acute bacterial meningitis (ABM), the proportion that are treated with antibiotics, and the proportion that have diognostic CSF sampling. Methods: Patients with an incident episode of CSE with fever were identified as part of an ongoing prospective population based study of CSE in childhood. Resu lts: There were 49 incident cases of CSE in the first six months. Ascertainment was 96%. Twenty four had CSE with fever, 16 had early parenteral antibiotics, n ine had diagnostic CSF sampling, and four had ABM. The population risk of ABM in CSE with fever was significantly higher than that of short seizures with fever (17%v 1.2%). Conclusions: The classical symptoms and signs of ABM may be abse nt in CSE with fever. A high index of suspicion for ABM in the child with CSE wi th fever is paramount. The most appropriate management is suggested to be early parenteral antibiotics and a lumbar puncture when there are no contraindications .
Aims: In children with convulsive status epilepticus (CSE)with fever, to deter mine the likelihood of acute bacterial meningitis (ABM), the proportion that are treated with antibiotics, and the proportion that have diognostic CSF sampling. Methods: Patients with an incident episode of CSE with fever were identified as part of an ongoing prospective population based study of CSE in childhood. Resu lts: There were 49 incident cases of CSE in the first six months. Ascertainment was 96%. Twenty four had CSE with fever, 16 had early parenteral antibiotics, n ine had diagnostic CSF sampling, and four had ABM. The population risk of ABM in CSE with fever was significantly higher than that of short seizures with fever (17%v 1.2%). Conclusions: The classical symptoms and signs of ABM may be abse nt in CSE with fever. A high index of suspicion for ABM in the child with CSE wi th fever is paramount. The most appropriate management is suggested to be early parenteral antibiotics and a lumbar puncture when there are no contraindications .
