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Abstract Meningitis remains one of the most feared infectious diseases worldwide and is associated with substantial mortality and long-term neurological complications. The current study was conducted on children ranged from two to twelve years with complete epidemiological profile, risk factors, clinical presentation, CSF analysis and serum Neopterin in different bacterial and non-bacterial types of meningitis. The present study was conducted at the meningitis department, Embaba Fever Hospital and it included two groups: First group: represent meningitis cases admitted in the hospital in one year (May 2012- May 2013) and Second group: represent the admitted meningitis cases in a period of one year (May 2013- May 2014). We found that the age ranged from 2-12 years with a mean of 7.2 +/-3.39 in the first group in comparison to the second group with a mean of 6.74 +/-3.18. In the current study the percentage of males was higher than females. The percentage of males was higher (63.3%) in the first group in comparison to the second group (56.8%), while the percentage of females was higher (43.2%) in the second group in comparison to the first group (36.7%).In the current study we found that there was no statistical significant difference ( p> 0.05) between both groups regarding cases attending school , the percentage was (62.2%) in the first group in comparison to the second group (61.7%). In the current study we found that there was a statistical significant difference (p =0.006) between both groups regarding cases were in contact to ill relative, the percentage was (47.8%) in the first group in comparison to the second group (27.2%). In the current study we found that there was no statistical significant difference between both groups regarding seasonal variation, there was a higher percentage in winter (38.9%, 35.8%) in first and second group respectively followed by spring (36.7%, 33.3%) in first and second group respectively, while in summer were (14.4%, 14.8%) in first and second group respectively and in autumn were (11.1%, 14.8%) in first and second group respectively. In the current study there was a statistical significant difference between both groups regarding photophobia, abdominal pain, and headache (p< 0.05). In the second group there was a higher percentage of fever (73%) in comparison to the first group (66.7%). In the second group there was a higher percentage of stiff neck (74.1%) in comparison to the first group (62.2%).In the second group there was a higher percentage of seizures (49.4%) in comparison to the first group (45.6%). Regarding systemic presentations, photophobia was higher in the first group (38.9%) in comparison to the second group (2.5%), nausea and vomiting were higher in the second group (71.6%) in comparison to the first group (66.7%), abdominal pain was higher in the first group (33.3%) in comparison to the second group (16.1%), while pharyngitis was higher in the first group (42.2%) in comparison to the second group (37.1%). There was a higher percentage of headache in the first group (66.7%) in comparison to the second group (37.1%) which is a significant sign of meningeal irritation. The least percentage was rash and petichiea, there was a higher percentage of rash and petichiea in the first group (4.4%) in comparison to the second group (1.2%). In the current study there was a higher percentage of improvement (79.1%) in the second group in comparison to the first group (73.3%), neurological complications occurred in (15.6%, 13.6%) in the first and second group respectively, death represent only (8.9%, 7.4%) in first and second group respectively.In the current study: There was a higher percentage (67.9%) of clear CSF indicating non bacterial cases in the second group in comparison to the first group (48.9%) with a statistical significant difference between both groups, and there was a higher percentage (51.1%) of turbid CSF indicating bacterial cases in the first group in comparison to the second group (32.1%) with a statistical significant difference between both groups, while the bloody CSF indicating tuberculous cases represent only 1.1% in the first group in comparison to the second group (0.00%). In the current study as regard CSF culture there was a higher percentage (32.2%) of no growth in the first group in comparison to the second group (14.8%), followed by St. pneumonia (9.9%) in the second group in comparison to the first group (5.6%), then H influenza (7.8%) in the first group in comparison to the second group (2.5%), then N. meningitides (3.3%) in the first group in comparison to the second group (2.5%), the lowest percentage was TB meningitis (1.1% and 0.00%) in the first and second group respectively. In the current study there was a higher percentage of use of antibiotics before admission in the first group (52.2%) in comparison to the second group (32.1%) with a statistical significant difference between both groups, this high percent indicating rushing of people to use antibiotics In the current study there was no statistical significant difference between both groups regarding the different antibiotics. There was a higher percentage of use of penicillin (68.9%) in the first group in comparison to the second group (61.7%), there was a higher percentage of use of ampicillin and ceftriaxon (66.7%) in the first group in comparison to the second group (61.7%) while there was a higher percentage of other antibiotics (7.8%) in the first group in comparison to the second group (2.5%). In the current study the mean +/- SD of serum Neopterin and CRP were (28.11+/- 12.01) and (28.19+/-31.34) respectively among the second group of patients. There was a statistical significant positive correlation between the bacterial meningitis and the higher level of serum neopetrin. |