Background and Objective: Purulent meningitis is a therapeutic emergency and remains a real public health problem in the world, particularly in limited resources countries. The study aimed to describe the epidemiologi...Background and Objective: Purulent meningitis is a therapeutic emergency and remains a real public health problem in the world, particularly in limited resources countries. The study aimed to describe the epidemiological clinical, etiological and scalable features of purulent meningitis in children in Bria. Methods: A cross-sectional descriptive study was conducted from January 1, 2018 to December 31, 2019 (24 months). It included all suspected cases of purulent meningitis in children aged 0 to 15 years, confirmed by agglutination with Pastorex meningitis. A standard sheet was used to collect the data which was entered and analyzed on Epi Info 7 software. Results: A total of 37 cases of purulent meningitis were confirmed among 90 suspected cases. The female gender predominated (59.5%), with a sex ratio of 0.7. The age group from 0 to 11 months was majority (48.6%). Nearly 2 thirds of children were not vaccinated (64.8%). The most frequent functional signs were fever (83.8%), and convulsion (51.4%). The etiologies were Streptococcus (51.4%), Neisseria meningitidis (35.1%) and Haemophilus influenzae (13.5%). Therapeutic success under 3rd generation cephalosporin treatment was obtained in 86.5% including 8.1% with sequelae;13.5% of death was observed. Streptococcus was the most lethal bacterium at 21.1%. Conclusion: The results of these studies show that pediatric purulent meningitis is still common despite the availability of free vaccination. They require early therapeutic management to limit the occurrence of sequelae and death. Hence, it is important to strengthen prevention strategies.展开更多
Introduction: In the North-Benin, there are three agents causing pediatric purulent meningitis outside the neonatal period. These are: Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b...Introduction: In the North-Benin, there are three agents causing pediatric purulent meningitis outside the neonatal period. These are: Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b. The aim of this research work was to investigate bacteria serotypes that caused childhood purulent meningitis in the pediatric unit of the Borgou à Regional University Teaching Hospital (CHUD-Borgou) located in Parakou (North-Benin). Patients and Methods: Through a prospective and descriptive study centered on children aged 0 to 5 years old suspected of meningitis and hospitalized, the cerebrospinal fluid (CSF) samples of those children were analyzed at the WHO reference laboratory in Banjul for serotyping by real time polymerase chain reaction (RT/PCR). Results: Among the 1396 children hospitalized during that period, 366 were suspected of meningitis and had benefitted from lumbar puncture. Among those 366 suspected cases, 51 cases of purulent meningitis were confirmed after CSF cytobacteriological and biochemical test at the CHUD-Borgou laboratory. Among 51 CSF samples in which purulent meningitis was confirmed, 44 were sent to Banjul. In addition, 310 CSF samples from non-confirmed cases of meningitis were also sent to Banjul. In the whole set of samples sent for real time PCR, 151 cases of Streptococcus pneumoniae (42.7%) were found, 5 cases of Neisseria meningitidis (1.4%) and 1 case of Haemophilus influenzae (0.3%) were also encountered. As regards Streptococcus pneumonia, the serotypes encountered were: 1, 3, 4, 5, 7F, 8, 9V, 9V/9A, 9N/9L, 14, 18C, 19A, 23F, 33F as well as non typed and non typable serotypes. As for Neisseria meningitidis, only serogroup A was found in it. For Haemophilus influenzae, only serotype b was identified. Conclusion: Four non vaccine serotypes (8, 9V/9A, 9N/9L and 33F), non typed and non typable serotypes which are not covered by 13-valent pneumococcal conjugate vaccine (PCV 13) were identified. This highlights the need to enhance surveillance of pediatric purulent meningitis and serotyping by RT/PCR of all CSF samples in order to adapt if necessary future new pneumococcal vaccines to circulating non vaccine serotypes.展开更多
BACKGROUND Bacterial meningitis(BM)is a common central nervous system inflammatory disease.BM may cause serious complications,and early diagnosis is essential to improve the prognosis of affected patients.CASE SUMMARY...BACKGROUND Bacterial meningitis(BM)is a common central nervous system inflammatory disease.BM may cause serious complications,and early diagnosis is essential to improve the prognosis of affected patients.CASE SUMMARY A 37-year-old man was hospitalized with purulent meningitis because of worsening headache for 12 h,accompanied by vomiting,fever,and rhinorrhea.Head computed tomography showed a lesion in the left frontal lobe.Infectious disease screening showed positivity for hepatitis B surface antigen,hepatitis B e antigen,and hepatitis B core antigen.Cerebrospinal fluid(CSF)leak was suspected based on clinical history.Streptococcus pneumoniae(S.pneumoniae)was detected in CSF by metagenomic next-generation sequencing(mNGS)technology,confirming the diagnosis of purulent BM.After treatment,multiplex PCR indicated the presence of hepatitis B virus(HBV)DNA and absence of S.pneumoniae DNA in CSF samples.CONCLUSION We report a rare case of HBV in the CSF of a patient with purulent BM.Multiplex PCR is more sensitive than mNGS for detecting HBV DNA.展开更多
文摘Background and Objective: Purulent meningitis is a therapeutic emergency and remains a real public health problem in the world, particularly in limited resources countries. The study aimed to describe the epidemiological clinical, etiological and scalable features of purulent meningitis in children in Bria. Methods: A cross-sectional descriptive study was conducted from January 1, 2018 to December 31, 2019 (24 months). It included all suspected cases of purulent meningitis in children aged 0 to 15 years, confirmed by agglutination with Pastorex meningitis. A standard sheet was used to collect the data which was entered and analyzed on Epi Info 7 software. Results: A total of 37 cases of purulent meningitis were confirmed among 90 suspected cases. The female gender predominated (59.5%), with a sex ratio of 0.7. The age group from 0 to 11 months was majority (48.6%). Nearly 2 thirds of children were not vaccinated (64.8%). The most frequent functional signs were fever (83.8%), and convulsion (51.4%). The etiologies were Streptococcus (51.4%), Neisseria meningitidis (35.1%) and Haemophilus influenzae (13.5%). Therapeutic success under 3rd generation cephalosporin treatment was obtained in 86.5% including 8.1% with sequelae;13.5% of death was observed. Streptococcus was the most lethal bacterium at 21.1%. Conclusion: The results of these studies show that pediatric purulent meningitis is still common despite the availability of free vaccination. They require early therapeutic management to limit the occurrence of sequelae and death. Hence, it is important to strengthen prevention strategies.
文摘Introduction: In the North-Benin, there are three agents causing pediatric purulent meningitis outside the neonatal period. These are: Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b. The aim of this research work was to investigate bacteria serotypes that caused childhood purulent meningitis in the pediatric unit of the Borgou à Regional University Teaching Hospital (CHUD-Borgou) located in Parakou (North-Benin). Patients and Methods: Through a prospective and descriptive study centered on children aged 0 to 5 years old suspected of meningitis and hospitalized, the cerebrospinal fluid (CSF) samples of those children were analyzed at the WHO reference laboratory in Banjul for serotyping by real time polymerase chain reaction (RT/PCR). Results: Among the 1396 children hospitalized during that period, 366 were suspected of meningitis and had benefitted from lumbar puncture. Among those 366 suspected cases, 51 cases of purulent meningitis were confirmed after CSF cytobacteriological and biochemical test at the CHUD-Borgou laboratory. Among 51 CSF samples in which purulent meningitis was confirmed, 44 were sent to Banjul. In addition, 310 CSF samples from non-confirmed cases of meningitis were also sent to Banjul. In the whole set of samples sent for real time PCR, 151 cases of Streptococcus pneumoniae (42.7%) were found, 5 cases of Neisseria meningitidis (1.4%) and 1 case of Haemophilus influenzae (0.3%) were also encountered. As regards Streptococcus pneumonia, the serotypes encountered were: 1, 3, 4, 5, 7F, 8, 9V, 9V/9A, 9N/9L, 14, 18C, 19A, 23F, 33F as well as non typed and non typable serotypes. As for Neisseria meningitidis, only serogroup A was found in it. For Haemophilus influenzae, only serotype b was identified. Conclusion: Four non vaccine serotypes (8, 9V/9A, 9N/9L and 33F), non typed and non typable serotypes which are not covered by 13-valent pneumococcal conjugate vaccine (PCV 13) were identified. This highlights the need to enhance surveillance of pediatric purulent meningitis and serotyping by RT/PCR of all CSF samples in order to adapt if necessary future new pneumococcal vaccines to circulating non vaccine serotypes.
文摘BACKGROUND Bacterial meningitis(BM)is a common central nervous system inflammatory disease.BM may cause serious complications,and early diagnosis is essential to improve the prognosis of affected patients.CASE SUMMARY A 37-year-old man was hospitalized with purulent meningitis because of worsening headache for 12 h,accompanied by vomiting,fever,and rhinorrhea.Head computed tomography showed a lesion in the left frontal lobe.Infectious disease screening showed positivity for hepatitis B surface antigen,hepatitis B e antigen,and hepatitis B core antigen.Cerebrospinal fluid(CSF)leak was suspected based on clinical history.Streptococcus pneumoniae(S.pneumoniae)was detected in CSF by metagenomic next-generation sequencing(mNGS)technology,confirming the diagnosis of purulent BM.After treatment,multiplex PCR indicated the presence of hepatitis B virus(HBV)DNA and absence of S.pneumoniae DNA in CSF samples.CONCLUSION We report a rare case of HBV in the CSF of a patient with purulent BM.Multiplex PCR is more sensitive than mNGS for detecting HBV DNA.
