Clinical Characteristics And CSF Interpretation Of Result: Eighty-three Neonatal Purulent Meningitis

Objective:To retrospectively analyze the 83 cases which diagnosis of neonatal purulent meningitis in the Children’s Hospital Of Kunming Medical University, to explore the correlation between neonatal purulent meningitis and Cerebral spinal fluid (CSF) routine, In time to get up early accurate diagnosis and treatment of purulent meningitis.Methods:Our new pediatric diagnosis of the 83 cases of neonatal purulent meningitis in the Children’s Hospital of Kunming Medical University as the research object from January 2012 to December,Clinical features and CSF interpretation of result, Statistical processing was analyzed retrospectively, including white blood cell count of degree increased,contrast quantitative correlation with clinical characteristics of protein and glucose.The results of clinical data were selected as the data of enumeration data or count data,two independent samples were tested for homogeneity of variance in enumeration data, Independent-samples t test was conducted using homogeneity of variance;Mann-Whitney U test was conducted using variance nonhomogeneity;count data was expressed as percentage,Correlation Analysis was applied to judge correlation.Results:1.Fever was the most common and earliest clinical symptoms (60.2%), followed by jaundice (31.3%),hyperspasmia (7.2%),cough (7.2%),abdominal distension (6.0%);2.This group of children with neonatal purulent meningitis in 83 cases,17 cases of early onset purulent meningitis(onset of day age≤7d)(20.5%),66 cases of late onset purulent meningitis(7d<onset of day age≤28d)(79.5%).delivery mode:26 cases of cesarean section(31.3%),57 cases of normal labor(68.7%).3.Cerebral spinal fluid examination results in 83 cases of neonatal purulent meningitis.For the first time,in the cerebral spinal fluid white blood cell count is higher,the higher the protein quantitative,r=4844.402>0,there is a positive correlation between both;In the cerebral spinal fluid white blood cell count is higher, the lower the glucose quantitative,r=-134.147<0,there is a negative correlation between both;In 83 cases,We first white blood cell count of CSF was greater than 20×106/L,cells were classified,We found 16 cases in mononuclear cells increased,9 cases in coenocyte increased,two groups of CSF glucose, there was no statistically significant difference quantitative comparison (t=1.369,P=0.184>0.05).there was no statistically significant difference compared to protein quantitative (t=-1.656,P=0.133>0.05)4.According to the difference degree of CSF the white blood cell count, were divided into 3 groups, Slightly,Moderate and Heavily increased group:the average length of hospital stay, respectively:(21.61±6.96) d, (22.65±7.73) d, (26.57±18.94) d;The proportion of fever in slightly, moderate and heavily increased group were 63.2%,26.5%,57.1%.The proportion of jaundice in slightly, moderate and heavily increased group were 31.6%,34.2%,14.3%.The proportion of hyperspasmia in slightly,moderate, heavily increased group were 31.6%,34.2%,14.3%. 5.The pathogen positive rate of slightly,moderate and heavily increased group were 15.8%,18.4%,57.1%;CSF to Blood culture positive rate was 15.7%,7 cases were Gram-positive bacteria(54%),6 cases were Gram-negative bacterium(46%); Whatever, cultivate positive rate was 4.8%,half of gram negative and positive bacteria.Conclusion:1.Fever was the most common and earliest clinical symptoms;2.Newborns in diagnosis of purulent meningitis, late onset purulent meningitis was more than early onset purulent meningitis; The mode of delivery, the children were natural labor in high incidence ratio of cesarean section production in children;3.According to the difference degree of CSF the white blood cell count, the cerebral spinal fluid white blood cell count is higher, treatment time is longer;4.Most newborn of pathogen positive rate happened in Heavily increased group, their clinical manifestation were severity, most of hyperspasmia;5.Newborns in diagnosis of purulent meningitis, Our NM cases positive rate of blood culture was higher than that of CSF culture, in the blood culture, with coagulase negative staphylococci,followed by Escherichia coli.