A Comparative Study according to Diagnostic Time on Meningitis

Purpose

Aseptic meningitis is relatively frequent in children and caused mostly by enterovirus. The aim of the present study was to determine the effect of early diagnosis(spinal tapping) on symptom duration of childhood aseptic meningitis.

Methods

One hundred fifty-three children who were hospitalized due to aseptic menigitis in the Department of Pediatrics St. Benedict Hospital from July 1996 through October 1996 were included in this study. Patients were divided to two groups according to the duration from first symptom onset to diagnosis. Early diagnosis group is diagnosed within 3 days from first symptom onset. Later diagnosis group is diagnosed after 4 days from first symptom onset.

Results

1) The average age of these patients was 4,3 years old in early diagnosis group and 4.1 years old in later diagnosis group. The sex ratio(male: female) was 2.04: 1 in early diagnosis group and 2.5: 1 in later diagnosis group.

2) The mean duration of diagnosis of this study was 2.04 day in early diagnosis group and 5.12 day in later diagnosis group.

3) The percentage of symptom and sign of the early diagnosis group were fever(100%), headache(88.4%), vomiting(86.9%), abdominal pain(39%), neck stiffness(36.2%), skin rash 18.8%), diarrhea(16.9%) and that of later diagnosis group were fever(100%), headache(83.3), vomiting(80.9%), abdominal pain(47.6%), neck stiffness(41.6%), skin rash(29.7%), diarrhea(16.6%).

4) Initial CSF findings revealed leukocyte 146.8±386.3/mm³ with PMNL 38%, protein 32.47mg/dl, sugar 66.23mg/dl in early diagnosis group and leukocyte 458.1±663.2/mm³, protein 31.22mg/dl, sugar 64.21mg/dl in later diagnosis group.

5) There was no statistically significant difference in the peripheral blood findings between early diagnosis group and later diagnosis group.

6) The duration of disappearance of symptom after spinal tap were 2.3 days in early diagnosis group and 2.24 days in later diagnosis group. Total symptom duration was 4.34 days in early diagnosis group and 7.36 days in later diagnosis group.

Conclusions

Our results demonstrate that early diagnosis(early spinal tap) shortened duration of clinical symptoms.