ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG VIÊM MÀNG NÃO MỦ Ở TRẺ SƠ SINH TẠI BỆNH VIỆN NHI ĐỒNG CẦN THƠ

Abstract

Background: Bacterial meningitis is one of serious infections, to neonates, clinical manifestations can be nonspecific and easily misdiagnosed. The identification of bacterial meningitis should be based on both clinical and subclinical features, in which the cerebrospinal fluid plays an essential role in diagnosis. Objectives: To describe clinical, preclinical features and cereborspinal fluid disorders in bacterial meningitis neonates admitted to Can Tho Children’s Hospital. Materials and methods: Case series report on 32 neonates diagnosed for bacterial meningitis at Neonatal Department of Can Tho Children's Hospital from June 2021 to June 2022. Results: Clinical features: fever was the most common clinical symptom of neonate’s manifestations with 53.1%. Symptoms of jaundice, respiratory distress system and seizure were more popular in early-onset neonatal infection; otherwise fever, wheezing and gastrointestinal symptoms were common in late-onset neonatal infection. Subclinical features: 12.5% leukopenia and 28.1% leukocytosis. There were 40.6% cases of increased CRP. Cerebrospinal fluid parameters: The average concentration of cerebrospinal fluid protein was 107.2mg/dL and there were 46.9% cases of increased protein concentration; the number of cerebrospinal fluid cells had a median of 20 cells/mm³ and 56.3% of cases increased cerebrospinal fluid cells; the concentration of cerebrospinal fluid glucose had a median of 50.4mg/dL and 3.2% of cases had decreased glucose concentration; CSF culture: 100% negative. Conclusion: Fever was the most common symptom and most often seen in the group of late-onset neonatal infection. The abnormal of cerebralspinal fluid cell count is the most sensitive in cerebralspinal fluid parameters. Cerebrospinal fluid glucose levels fluctuated significantly, which was rarely used for diagnosing of bacterial meningitis.