Retrospective analysis of biochemical and microbiological analyzes of patients hospitalized in the pediatric intensive care unit with the diagnosis of meningitis and undergoing lumbar puncture

Meningitis is a central nervous system infectious disease with inflammation of the leptomeninges and subarachnoid space. Despite advances in diagnostic tests and treatment methods, it still has serious mortality and morbidity. Therefore, it is very important to make an early diagnosis and start empirical treatment for the causative agent as soon as possible. Seventy patients diagnosed with meningitis in our hospital were included into this study .The anamnesis , physical examination, laboratory results, and initiated treatments of these patients were retrospectively reviewed. The majority of our patients (58.6%) are male and 38.6% are 1 year old or younger. The total number of patients who refer to the hospital in the spring and summer months is higher than the ones who refer to the hospital in the autumn and winter months. The most common complaint of our patients was fever with 84.3%. Meningeal irritation sign is 86% positive in patients aged 2 years and older, while this rate is 22.4% under 2 years of age. A statistically significant difference was found in terms of neutrophil, lymphocyte, and platelet values according to the meningeal irritation findings (p <0.05). The neutrophil values of those with positive signs of meningeal irritation were significantly higher than those without signs of meningeal irritation. The lymphocyte and platelet values of those with positive signs of meningeal irritation were significantly lower than those without meningeal irritation signs. When the blood and CSF analyzes of the patients were examined, the median values were 11.5 g/dL for hemoglobin, 11220/uL for leukocytes, 321500/uL for platelets, 25.9 mg/dl for CRP, 29 mm/h for ESR, 61.2 mg/dL for CSF glucose, 37.4 for CSF protein and 100/mm3 for the number of cells. The causative microorganism was detected in the CSF culture in 4 of our patients. In 3 of the culture-negative patients, the causative pathogen was detected in the CSF PCR. The most preferred empirical antimicrobial therapy initiated for patients is the combination of vancomycin and a third-generation cephalosporin. Keywords: Meningitis, Fever, Meningeal Irritation Signs, Cerebrospinal Fluid