بررسی فراوانی مننژیت در کودکان بستری با تب و تشنج در بخش کودکان بیمارستان حضرت رسول اکرم(ص) در سال‌های 1381-1376

Seizure due to fever is very common during childhood. It can simply be associated with fever without a focus for infection or can be the presenting sign of localized infections, including central nervous system infections. It is difficult to exclude meningitis merely on the basis of physical findings in children with febrile seizure under the age of 18 months. So, performing a lumbar puncture(LP) is a valuable diagnostic procedure in this group. However, despite many clinical studies in this regard, there is still controversy over doing LP. This cross-sectional retrospective study was undertaken to evaluate files of 245 patients with febrile seizure who were between 5 months and 6 years of age and were admitted to the pediatric ward of Hazrat Rasoul Hospital over a period of 5 years(1997-2002). The objective was to study children with febrile seizure to determine the necessity of performing LP in this group. Of 254 patients with mean age of 28.5±18.3 months, 206(84%) had simple febrile seizures, while 39(16%) presented with complex febrile seizure. Analysis of CSF in 9(3.6%) patients were compatible with meningitis. 4 out of 9 patients had bacterial meningitis. Mean age of children with meningitis was 13±4 months. All children with febrile seizure and underlying meningitis were under the age of 18 months and this was their first episode of febrile seizure and none of them had clinical signs of meningitis. In those with meningitis 56.6% had complex febrile seizure. 3(75%) children with bacterial meningitis and 2(40%) of those with aseptic meningitis had complex febrile seizures. Chi2 test results showed a significant relation(Pvalue<0.05) either between type of seizure and incidence of meningitis or type of seizure and incidence of bacterial meningitis. According to this study, meningitis was not a common finding in children with febrile seizure. However, we recommend performing LP in all children with febrile seizure under the age of 18 months. Meningitis should especially be excluded in children with complex febrile seizure.