Meningitis in Children

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I. Response to therapy: Patients normally improve in 48 hours. The signs of poor response include persistent opisthotonus, seizures, coma or altered mental status, and signs suggesting CNS complications (focal neurologic deficit, enlarging head circumference, ataxia, persistent seizures, prolonged coma and altered mental status).

J. The mortality for bacterial meningitis in the neonatal period is 12-20%, in infants and children 3-10%. Language disorders, sensorineural deafness, mental retardation, seizures are some common sequelae to meningitis.
K. Signs of CNS complication are focal neurologic deficit, enlarging head circumference, ataxia, persistent seizures, prolonged coma and altered mental status .A CT scan will identify CNS pathology such as subdural empyema, cerebral edema, cerebral abscess, cerebral infarction, or hydrocephalus.


Age Antibiotic of choice
Neonates 0-72 hours
Ampicillin and gentamicin or
Cefotaxime with Ampicillin or Penicillin
Neonates>72hours

Cefotaxime with Ampicillin or Penicillin
Add cloxacillin if Staph aureus is suspected
Infants Ampicillin and chloramphenicol or Ceftrioxone
Older children Ceftrioxone or cefotaxime or penicil lin if strep Pneumonia is suspected Refer table1

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