Incidence of meningitis in infants, ages 6 to 12 months, with first episode of fever with seizures at Kalasin hospital

Abstract

Introduction : Febrile seizures are the most common problem in pediatric neurology. Seizure is a common symptom among patients presenting with bacterial meningitis. Meningitis is life-threatening illness which require prompt diagnosis and aggressive treatment.

Objective : The objective of this study was to describe the rate of meningitis in infant, ages 6 to 12 months, with first episode of fever with seizure (one tonic - clonic seizure lasting less than 15 minutes in a 24 - hour period), with an unremarkable history and normal physical examination.

Methodology : A retrospective descriptive study based on medical record was done. The subjects were infant 6 - 12 months of age presenting with first episode of fever with seizure (one tonic-clonic seizure lasting less than 15 minutes in a 24 - hour period ) at Kalasin Hospital during January 1st, 2011 to December 31st, 2014. Lumbar puncture have been performed in all cases and the CSF profiles were recorded.

Results : During the four-year period of the study, a total of 62 patients presented with first episode of fever with seizure(one tonic-clonic seizure lasting less than 15 minutes in a 24 - hour period ) and had a lumbar puncture. The mean age was 9 months. Thirty nine patients (62.9%) out of 62 were male. Thirty nine patients (62.9%) had seizure in the first day of fever. Twenty patients (32.3%) had seizures during the second day of fever. The body temperature was mostly between 38.1– 39.0 °C (45.2%). Twenty patients (32.3%) had family history of febrile seizure. Thirty two percent of patients had seizures 1 minute in duration. Thirty three patients (53.2%) had generalized tonic clonic seizure. Twenty nine patients (46.8%) had generalized tonic seizure. The cause of fever was mostly from upper respiratory tract infections (22.6%). All patients had an unremarkable histories and normal neurological examinations. Sixty one patients (98.4%) with febrile seizure had normal cerebrospinal fluid profiles. One patient (1.6%) had an abnormal cerebrospinal fluid profile,suggestive of bacterial meningitis.

Conclusions : Incidence of meningitis in infants, ages 6 to 12 months, with first episode of fever with seizure(one tonic - clonic seizure lasting less than 15 minutes in a 24 - hour period ) at Kalasin hospital was 1.6 %. Performing routine lumbar puncture is still necessary for early diagnosisand management of meningitis, and to reduce resulting morbidity and mortality rates in this patient population.

Keyword : first simple febrile seizure, meningitis