Complications, sequelae and case fatality rate in pediatric patients with meningitis in Dominican Republic

Abstract

Objective: To Determine the most frequent complications in pediatric patients with meningitis, to define the most common sequelae and to correlate pathological history with deaths due to meningitis. Background: Multiple cases of meningitis have been diagnosed and treated in the Dominican Republic, however, there are currently limited epidemiological data on this disease, in which complication factors and case fatality rate are pointed out. Design/Methods: It is a retrospective, probabilistic, randomized, descriptive study where 115 patients diagnosed with meningitis were selected from 2010 January 1st to December 31st 2020, older than 2 months to 14 years. Clinical records were reviewed and the data was processed and tabulated in Excel using frequencies and percentages. Results: 51.3% (59/115) of the cases affected by meningitis were male and the most frequent ages were 1 to 4 years old (36.52%;42/115), followed by 2 months to 1 year of age (28.70%; 33/115). 42.60% (49/115) patients had intrahospital complications, the most common were acute diarrheal disease (18.37%;9/49), sepsis (14.29%;7/49) and seizures (12.24%;6/49;). 69.38% (34/49) patients with complications had some type of pathological history, the most common being tonsillitis (23.53%;8/34), ventriculoperitoneal shunt placement (20.58%;7/34), and hydrocephalus (20.58%;7/34). After discharge 32.17% (37/115) had long-term sequelae such as epilepsy (32.43%;12/37), headache (29.73%;11/37) and delayed motor development (16.22%;6/37). The case fatality rate in patients with meningitis was 7.83% (9/115), of which 88.89% (8/9) suffered from bacterial meningitis, 66.67% presented sepsis (6/9), 22.22% (2/9) had a ventriculoperitoneal shunt and 22.22% (2/9) were premature. The most affected age range was from 2 months to one year (55.55%;5/9). Conclusions: Meningitis is a lethal disease that, if not treated and diagnosed in time, can present complications and serious sequelae, as evidenced in this study. The risk of death is higher from bacterial meningitis and during the first year of life.