20 October 2015 : Clinical Research
Surgical Treatments for Infantile Purulent Meningitis Complicated by Subdural Effusion
Xianshu WangABDEF, Xiaoru ZhangABC, Hongbin CaoBCD, Shiyuan JingDEF, Zhiguo YangBF, Zhenghai ChengDF, Ye LiuEF, Xin LiCE, Feifei GaoCF, Yuanqi JiAFDOI: 10.12659/MSM.895747
Med Sci Monit 2015; 21:3166-3171
Abstract
BACKGROUND: Infantile purulent meningitis (PM) is a commonly severe intracranial infectious disease in infants under age 1 year. In recent years, several diagnostic and treatment methods were reported, but in these cases the neurological complications and sequel were often observed, among which subdural effusion (SE) is the most common complication in PM. Timely diagnosis and early intervention are vital for better outcomes. In this study, the surgical treatments for infantile PM complicated by SE were investigated.
MATERIAL AND METHODS: Patients who had PM complicated by SE in the Children’s Hospital of Hebei Province from June 2000 to June 2012 were retrospectively analyzed and 170 patients were enrolled in the study. Surgical treatment for each patient was adopted according to producing effusion time, leucocyte count, protein content, intracranial pressure, and bacteria culture, coupled with cranial ultrasound examination, CT, and MRI scans.
RESULTS: Nearly, 15 patients were cured using serial taps, with a 50% cure rate. Seventeen out of 30 (56.6%) patients receiving subcutaneous reservoir drainage had better outcome. Nearly 80% of patients (55/69) who underwent minimally invasive trepanation and drainage were positive. Surgical procedure of minimally invasive trepanation and drainage combined with drug douche was effective in 63% of patients (19/30). In addition, 6 patients were cured with subdural-peritoneal shunt. Only 1 patient died, after the recurrence of meningitis, and the remaining 4 patients were cured by craniotomy.
CONCLUSIONS: For infantile PM complicated with SE, treatment needs be chosen according to the specific situation. Surgical procedure of minimally invasive trepanation and drainage is a very effective treatment in curing PM complicated by SE. The treatment was highly effective with the use of drug douche. Subdural-peritoneal shunt and craniotomy were as effective as in refractory cases.
Keywords: Drainage - methods, Craniotomy, Infant, Newborn, Intracranial Pressure, Leukocyte Count, Magnetic Resonance Imaging, Meningitis, Bacterial - surgery, Neurosurgical Procedures - methods, Postoperative Complications - etiology, Recurrence, Subdural Effusion - complications, Tomography, X-Ray Computed
Editorial
01 August 2022 : Editorial
Editorial: Long-Term Effects of Symptomatic and Asymptomatic SARS-CoV-2 Infection in Children and the Changing Pathogenesis of Common Childhood Viruses Driven by the COVID-19 PandemicDOI: 10.12659/MSM.937927
Med Sci Monit 2022; 28:e937927
In Press
12 Aug 2022 : Clinical Research
Risk Factors and Pathogen Spectrum in Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis: A S...Med Sci Monit In Press; DOI: 10.12659/MSM.937112
11 Aug 2022 : Meta-Analysis
Optimal Surgical Treatment Method for Anterior Cruciate Ligament Rupture: Results from a Network Meta-AnalysisMed Sci Monit In Press; DOI: 10.12659/MSM.937118
10 Aug 2022 : Review article
Programmed Cell Death in Diabetic Nephropathy: A Review of Apoptosis, Autophagy, and NecroptosisMed Sci Monit In Press; DOI: 10.12659/MSM.937766
10 Aug 2022 : Database Analysis
Use and Effects of Augmentation of Labor with Oxytocin: A Single-Center, Retrospective, Case-Control Study ...Med Sci Monit In Press; DOI: 10.12659/MSM.937557
Most Viewed Current Articles
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292
01 Nov 2020 : Review article
Long-Term Respiratory and Neurological Sequelae of COVID-19DOI :10.12659/MSM.928996
Med Sci Monit 2020; 26:e928996