Partially Treated Bacterial Meningitis: The Dilemma Continues

 Authors

Groob Alkhayer, Maiass El Homsi and Mhd Nezar Alsharif

Published in

World Journal of Pharmaceutical Research, Volume 7, Issue 10, 2 1-29

Abstract

Objective: This study aimed to determine the effect of pretreatment with antibiotics before lumbar puncture on cerebrospinal fluid profile(CSF) compared with the CSF results’ of patients who were not pretreated with antibiotics. Methods: This is a retrospective study composed of all children (newborns until 12 years old); who reviewed the Children University Hospital Between 1/1/2015 and 20/11/2017 and were diagnosed with acute bacterial meningitis. Results: A total of 55 children were diagnosed with acute bacterial meningitis and were included in this study. However only 23.6% (13 cases) of all patients received antibiotics before cerebrospinal fluid analysis (CSF) and those were studied to determine the changes due to the pretreatment. Those patients (13 patients) CSF results’ revealed decreased WBC (white blood cell count) in 38.4% of them, lymphocyte dominance in 61.5% of them, 62% of their culture results were sterile, high glucose levels in 38.4% cases and low protein levels in (23% of them). Cefiriaxone was the most common antibiotic given in this study and it caused significant differences in the CSF profile.

Conclusion: We cannot dogmatize that prior treatment may cause a complete change in the CSF analysis results, and suggest a diagnosis of another form of meningitis based on the CSF profile, but we are confident that the inappropriate pre-treatment will blur the diagnosis of bacterial meningitis and make it harder to establish.

Keywords

Acute bacterial meningitis; antibiotic pretreatment; CSF analysis

Links 

www.wjpr.net/dashboard/abstract_id/10227