Chirag Saluja
Chirag Saluja(Post Graduate,Department of Pediatrics, Safdarjung Hospital New Delhi,India)
Title: Prevalence of meningitis in the first episode of febrile seizure in children aged between 6 to 18 months.
Biography
Biography: Chirag Saluja
Abstract
Background : Febrile seizures (FS) are the most common type of childhood seizures, affecting 2–5% of children older than 1 month and most commonly from 6 months–5 years old. It is a major cause of paediatric admissions worldwide. In India, AAP 2010 guidelines are followed for performing Lumbar Puncture(LP) in first episode of febrile seizure despite India having wide difference in the epidemiology of meningitis and immunisation coverage as compared to USA. This study has been done to find out whether AAP guidelines are applicable in India also or there is a need for our own guidelines.
Aims and objectives :
Primary Objective-To find out the prevalence of meningitis in first episode of febrile seizure in children aged 6 to 18 months.
Secondary Objective-To find out predictors of meningitis in in children with first episode of febrile seizure
Materials and Methods: A cross-sectional study over a period of 18 months was carried out in paediatric wards of Safdarjung Hospital. LP was performed and results analysed for meningitis as per guidelines.
Results: 200 cases were analysed. The prevalence of meningitis in children aged 6 to 18 months presenting with first episode of Febrile Seizure was 16%.Bacterial Meningitis was seen in 3%.The independent predictors of meningitis were high TLC(>16500/mm3),positive CRP and prematurity. High grade fever(>102ËšF),high seizure duration(>12 minutes),low MCV(<75fl),malnutrition(lesser weight for age) and longer post ictal state duration(>14 minutes) were seen as predictors of meningitis but after logistic regression they were not found to be independent predictors. Streptococcus pneumoniae was the most common organism isolated in the blood(42.8%) as well as the CSF(50%) of the cases taken. Most common type of cell seen were monocytes which were alone seen in 56.2% of the meningitis cases.
Conclusion: India needs its own guidelines for performing LP in cases of first episode of FS. Meningitis can be predicted in those with high TLC(16500/mm3), CRP positive and who are prematurely born.