Kansenshogaku Zasshi
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
Clinical Analysis of Patients with Bacterial Meningitis in Childhood and Reevaluation of Rapid Antigen Detection Methods
Akira NAKAMURAHaruo KUROKIHiroko OHSHIMATatsuya SUGIOKANaruhiko ISHIWADANobue TAKEDAJiro AIZAWAKiyofumi OHKUSU
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1999 Volume 73 Issue 9 Pages 901-908

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Abstract

Twenty-eight cases of bacterial meningitis during the recent ten years were analyzed retrospectively, and the following results were obtained.
1. Pathogens were as follows; H. influenzae 13 (46.4%), S. pneumoniae 8 (28.6%), S. agalactiae 4 (14.3%), E. coli 2 (7.1%), and L. monocytogenes 1 case (3.6%).
2. Twelve out of the thirteen H. influenzae cases were caused by serotype b (Hib), and 2 strains were β-lactamase producer. Fifty percent of the S. pneumoniae cases were caused by penicillinresistant strains. And all these resistant strains belonged to serotype 19 or 23.
3. Underlying diseases related to the onset of meningitis were found in 46% of the cases, and these consisted of CNS shunt operated 5, asplenia or polysplenia 2, Mondinrs anomaly 1, sacral dermal sinus 1, and neonate 4 cases.
4. Prognosis of these cases were three deaths, four with neurologic sequelae, and twenty-one complete recoveries.
5. On admission, 85% (17/20) of the cases were diagnosed correctly by the rapid antigen detection. Sensitivity and specificity of the rapid antigen detection by using latex particle agglutination is 90% and 100% in the Hib cases, and 83% and 100% in the S. pneumoniae cases respectively. Moreover, the bacteriologically unknown 2 cases caused by parenteral partial treatment were also diagnosed by the detection of antigen in concentrated urine.

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© The Japansese Association for Infectious Diseases
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