Ann Trop Paediatr
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Review Case Reports
Neonatal meningitis due to Moraxella catarrhalis and review of the literature.
Moraxella catarrhalis has been reported with increasing frequency to be the aetiological agent of serious systemic infection in both children and adults. The first case of neonatal meningitis due to this organism is described herein. The fatal outcome and causes of failure of response to antimicrobial therapy are also discussed. A brief review of the literature describing the disease entities with which M. catarrhalis has been associated is presented.
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Clinical Trial
Dexamethasone adjunctive therapy for bacterial meningitis in children: a retrospective study in Brazil.
The clinical records of 87 children with bacterial meningitis treated with antibiotics (group 1) and of 92 treated with antibiotics plus dexamethasone (group 2), admitted to the Instituto Materno Infantil de Pernambuco, Recife, Brazil over 2 consecutive years (1991 and 1992), were analysed. There were no significant differences between treatment groups regarding characteristics on admission except that group 1 were younger. The overall case fatality rate was 19%, with 14% in group 2 and 24% in group 1 (p = 0.09). ⋯ Among children aged 6-59 months, those treated with dexamethasone compared with those treated with antibiotics alone had a better case fatality rate (11% vs 25%; p = 0.05) and a better rate of discharge without sequelae (73% vs 52%; p = 0.02). Among the cases with a CSF culture positive for Haemophilus influenzae, 77% were discharged without sequelae in group 2 compared with 51% in group 1 (p = 0.03). The addition of dexamethasone to standard antibiotic treatment improves the outcome of children between 6 and 59 months of age admitted to hospital with a diagnosis of bacterial meningitis.