CLINICAL FEATURES AND COMPLICATIONS OF BACTERIAL MENINGITIS IN CHILDREN

Abstract

Relevance: Bacterial meningitis (BM) remains a significant cause of neurological complications and high mortality among children. Aim: to study the clinical features of BM in children to optimize the diagnosis and etiopathogenetic therapy. Methods: The object of the study is children diagnosed with meningitis, treated at the Multidisciplinary City Children's Hospital No. 3 in Astana, for the period from 2015 to 2023. Study design: prospective, control - case. Methods included clinical examination, complete blood count, cerebrospinal fluid test, CT and brain MRI. Descriptive statistics and Pearson's method were used for statistical processing. Results: Introduction of the PCV13 vaccine led to a fourfold decrease in the incidence of pneumococcal meningitis, while cases of meningococcal meningitis declined 1.6 times from 2014 to 2023. The main clinical manifestations in children with BM included high fever (80–90% of patients, with febrile temperatures ranging from 38.7°C to 39.9°C), neurological deficits, and complications: seizures and cognitive impairment developed in 50% of children. Hypertensive syndrome was observed in 81.8% of children with pneumococcal meningitis (PM), and in 55.6% of meningococcal meningitis (MM) cases among children under one year old. Pneumococcal CNS involvement was characterized by focal symptoms in 45.5% of young children, while such changes were statistically significantly lower in MM cases—threefold less (16.7%, p≤0.001). Spearman’s correlation analysis in the PM group showed a strong direct positive relationship between the following variables: delayed medical consultation and hospital stay duration (r=0.7; p≤0.001), delayed diagnosis and hospital stay duration (r=0.7; p≤0.001). Conclusion: PCV13 vaccination has significantly reduced the incidence of pneumococcal meningitis, which presents most severely, with early neurological complications in 41.5% of cases, cerebral edema in 90.9% of infants, and hypertensive syndrome in 81.8%. Early diagnosis and timely treatment contribute to the prevention of both early and late neurological complications.