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Clinical Features and Risk Factors for Adverse Prognosis of Childhood Purulent Meningitis and Tuberculous Meningitis

QIU Yan-ping;JIAO Yan-ping;ZHANG Xiao-xing;HAO Li-xia;Baoji Maternity & Child healthcare Hospital;Department of Neonatology,Hospital of Yanan University;  
Objective: To compare the clinical features and risk factors of adverse prognosis between childhood purulent meningitis(PM) and tuberculous meningitis(TBM). Methods: The clinical data of 70 cases PM and 44 cases TBM were collected. The clinicall features between the two groups were compared. The risk factors of adverse prognosis of two groups were analyzed by univariate analysis and multiariable logistic regression analysis.Results: High rate of meningeal irritation was clinical feature of PM(P=0.004). Meanwhile, the level of cerebrospinal fluid(CSF)- chloride in PM group was higher than that in TBM patients(P=0.020). Univariate analysis showed that the factors related to adverse prognosis of PM patients included age, disturbances of consciousness and CSF-glucose(P=0.001, 0.013, 0.031 respectively). The clinical staging was the only factor related to adverse prognosis of TBM(P=0.039). Multiariable logistic regression analysis showed that age(OR=1.811, 95%CI 1.911-2.755, P=0.006) and disturbances of consciousness(OR=0.099, 95% CI 0.017- 0.584, P=0.011) were associated with the adverse prognosis of PM. The clinical stage(OR=0.227, 95%CI 0.081-0.633, P=0.005) was associated with the adverse prognosis of PM. Conclusion: Meningeal irritation and the level of CSF-chloride could be the important indexes for the differential diagnosis between the two diseases. For children with PM, age and disturbances of consciousness were independent risk factors for adverse prognosis. Meanwhile, the clinical stage was the only independent risk factor for adverse prognosis of TBM.
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