Pediatric Meningoencephalitis; A Research on Patients Hospitalized in Zahedan, Southeastern Iran

Meningitis is a life-threatening disease and can lead to significant sequelae. Pediatric bacterial meningitis leaves some survivors with more significant sequelae if not treated, promptly. The advent of vaccine has changed the incidence of pediatric bacterial meningitis but these vaccines have not been used in routine childhood immunization schedule. The current study aimed to investigate the epidemiology, clinical features, etiologic agents and clinical outcome of meningencephalitis among the pediatric group in Zahedan, Iran. The current cross-sectional and descriptive study investigated the medical records of the patients with meningitis from May 2010 to May 2014. Then, the patients were evaluated according to sex, age, clinical feature, risk factor, etiologic agents, acute or chronic form, and clinical outcome. Among 55 patients with meningitis (42% girls and 58% boys; mean age of 8.5 months, age range of 45 days to nine years), 55 cases (98%) had acute meningoencephalitis and only one case (2%) had chronic tuberculous (TB) meningitis. Out of the 54 cases with acute disease, only six cases showed a positive test for etiologic agent. Forty-eight patients had negative CSF culture. The most common clinical symptom was fever (95%) and the least was seizure (16%). Mortality rate was 7.2% (four cases). There were no significant risk factors in children with illness, but there was a history of pulmonary TB in grandmother of the case with TB meningitis. According to the obtained results, and finding a high negative cerebro-spinal fluide (CSF) culture in acute meningitis, it is recommended to use systems to detect the bacteria more, particularly in the patients whose parents use antibiotics before referring to a physician. Also, more specific viral tests are needed to detect the etiologic agents of viral meningitis