ABSTRACT
In a prospective study extended along an 8 months period from July 2006-Feb .2007 , 116 patients were collected , from the admission to the department of pediatrics , Maternity and children hospital in Nassiryia city (MCH), with suspicion of meningitis .they were clinically evaluated for the signs and symptoms of meningitis , and the CSF analysis was the final diagnostic tool for meningitis .the patients were divided into 6 age groups ,and the sensitivity , specificity ,positive predictive value and the accuracy for the symptoms and signs of meningitis were calculated for each age group .
In the age group <1 month of age :convulsion was the most sensitive symptom, while lethargy was the most sensitive sign .
In age group 1-6 months : fever and convulsion were the most sensitive symptoms , while bulging fontanel , lethargy and irritability were the most sensitive signs .
In the age group 7-12 months : vomiting ,fever and convulsion were the most sensitive symptoms , while bulging fontanel, lethargy and neck rigidity were the most sensitive signs .
In the age group 1-5 years : vomiting headache ,fever and anorexia were the most sensitive symptoms , while lethargy and neck rigidity were the most sensitive signs .
In the age group 6-10 years : vomiting ,headache and fever were the most sensitive symptoms , while neck rigidity was the most sensitive sign .Irritability ,Kernig sign and back pain were less sensitive signs .
In the age group 6-15 : vomiting ,headache and fever were the only sensitive symptoms while lethargy, Kering sign and neck rigidity were the only sensitive signs
From this study we can conclude that for each age group there are some signs and symptoms sensitive for the diagnosis of meningitis different from the other age groups ..Performing lumber puncture in doubtful cases of meningitis is better than missing a case of meningitis with it is sequelae. |