neonatal meningitis: risk factors, causes, and neurologic complications

how to cite this article: khalessi n, afsharkhas l. neonatal meningitis: risk factors, causes and neurologic complications. iran j child neurol. 2014 autumn;8(4): 46-50. abstract objective neonates are at greater risk for sepsis and meningitis than other ages and in spite of rapid diagnoses of pathogens and treatments, they still contribute to complications and mortality. this study determines risk factors, causes, and neurologic complications of neonatal meningitis in  ospitalized neonates. material & methods in this descriptive, cross sectional study, we evaluated 415 neonates with sepsis and meningitis admitted to the neonatal intensive care unit at our center between 2008 and 2012. the data that was recorded was age, sex, birth weight, prenatal risk factors, clinical features, blood and cerebrospinal fluid analysis, and brain sonographic findings and outcomes. results twenty patients had meningitis. eleven cases (55%) were male. the mean age was 8. 41 days and mean birth weight was 2891.5±766 grams. poor feeding, seizures, and tachypnea were detected in 12 (60%), 11 (55%), and 6 (30%) patients, respectively. prenatal risk factors were prolonged rupture of membranes, maternal vaginitis, asymptomatic bacteriuria, prematurity, low birth weights, and asphyxia. four patients had positive cerebrospinal fluid cultures with klebsiella pneumoniae 2 (50%), enterococcus spp. 1 (25%), and group b streptococcus 1 (25%) cases, respectively. two cases had positive blood cultures with klebsiella pneumoniae. neurologic complications were brain edema, subdural effusion, and brain abscesses with hydrocephaly. one neonate (5%) died. conclusion our study provides some information about risk factors, pathogens, and neurologic complications for neonatal meningitis. prenatal assessments help to diagnose and reduce risk factors of this hazardous disease.  references volpe jj. bacterial and fungal intracranial infections. in:neurology of the newborn. 5th. edition. philadelphia, pa: saunders elsevier.2008. pp:916-56. aletayeb m, farajzadeh s, dehdashtian m. eleven-year study of causes of neonatal bacterial meningitis in ahvaz, iran pediatrics international 2010; 52, 463–466. edwards ms, baker cj. sepsis in the newborn. in:  gershon a, hotez pj, katz sl, editors. krugman’s infectious diseases of children, 11th edition. philadelphia: mosby. 2004. pp: 545-561 hristeva l, booy r, bowler i, wilkinson ar. prospective surveillance of neonatal meningitis. arch. dis. child. 1993; 69: 14–8. klein jo. bacterial meningitis and sepsis. in: remington js, klein jo (eds.). infectious diseases of the fetus and newborn infant. 4th edition wb saunders, philadelphia, pa. 2006.pp: 943–98. klinger g, chin cn, beyene j, et al. predicting the outcome of neonatal bacterial meningitis. pediatrics. sep 2000; 106(3):477-82. tiskumara r, fakharee sh, liu c-q, nuntnarumit p, lui k-m, hammoud m, et al. neonatal infections in asia. arch dis child fetal neonatal ed. march 2009; 94: 144-8. zaidi ak, thaver d, ali sa, khan ta. pathogens associated with sepsis in newborns and young infants in developing countries. pediatr infect dis j. 2009 jan; 28(1suppl):s10-8. muhe l, tilahun m, lulseged s et al. etiology of pneumonia, sepsis, and meningitis in infants younger than three months of age in ethiopia. pediatric. infect. dis. j. 1999; 18(suppl. 1): 56–61. garges hp, moody ma, cotten cm, et al. neonatal meningitis: what is the correlation among cerebrospinal fluid cultures, blood cultures, and cerebrospinal fluid parameters? pediatrics. apr 2006; 117(4):1094-100. edwards ms. neonatal sepsis. in martin rj, fanaroff aa, walsh mc, editors. fanaroff and martin’s neonatal-perinatal medicine. diseases of the fetus and infant, 9 th edition. philadelphia: elsevier mosby.2010. pp:806- 09. laving am, musoke rn, wasunna ao, revathi g. neonatal bacterial meningitis at the newborn unit of kenyatta national hospital. east afr. med. j. 2003; 80:456–62. chang chien hy, chiu nc, li wc, huang fy. characteristics of neonatal bacterial meningitis in a teaching hospital in taiwan from 1984–1997. j. microbiol. immunol. infect. 2000; 33: 100–4. kavuncuoglu s, gursoy s, turel o, aldemir e, hosaf e. neonatal bacterial meningitis in turkey: epidemiology, risk factors, and prognosis j infect dev ctries 2013; 7(2):073-081. gerdes js diagnosis and management of bacterial infections in the neonate. pediatr clin nam. 2004; 51: 939-959. yikilmaz a and taylor ag. sonographic findings in bacterial meningitis in neonates and young infants. pediatric radiology 2008; 38: 129-137.