Suboptimal management of central nervous system infections in children: a multi-centre retrospective study
<p>Abstract</p> <p>Objective</p> <p>We aimed to audit the regional management of central nervous system (CNS) infection in children.</p> <p>Methods</p> <p>The study was undertaken in five district general hospitals and one tertiary paediatric hos...
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doaj-18030e1d839a4b898bde8b0a485a7a862020-11-25T02:18:56ZengBMCBMC Pediatrics1471-24312012-09-0112114510.1186/1471-2431-12-145Suboptimal management of central nervous system infections in children: a multi-centre retrospective studyKelly ChristineSohal AmanMichael Benedict DRiordan AndrewSolomon TomKneen Rachel<p>Abstract</p> <p>Objective</p> <p>We aimed to audit the regional management of central nervous system (CNS) infection in children.</p> <p>Methods</p> <p>The study was undertaken in five district general hospitals and one tertiary paediatric hospital in the Mersey region of the UK. Children admitted to hospital with a suspected CNS infection over a three month period were identified. Children were aged between 4 weeks and 16 years old. Details were recorded from the case notes and electronic records. We measured the appropriateness of management pathways as outlined by national and local guidelines.</p> <p>Results</p> <p>Sixty-five children were identified with a median age of 6 months (range 1 month to 15 years). Ten had a CNS infection: 4 aseptic meningitis, 3 purulent meningitis, 3 encephalitis [2 with herpes simplex virus (HSV) type 1]. A lumbar puncture (LP) was attempted in 50 (77%) cases but only 43 had cerebrospinal fluid (CSF) available for analysis. Of these 24 (57%) had a complete standard set of tests performed. Fifty eight (89%) received a third generation cephalosporin. Seventeen (26%) also received aciclovir with no obvious indication in 9 (53%). Only 11 (65%) of those receiving aciclovir had CSF herpes virus PCR. Seventeen had cranial imaging and it was the first management step in 14. Treatment lengths of both antibiotics and aciclovir were highly variable: one child with HSV encephalitis was only treated with aciclovir for 7 days.</p> <p>Conclusions</p> <p>The clinical management of children with suspected CNS infections across the Mersey region is heterogeneous and often sub-optimal, particularly for the investigation and treatment of viral encephalitis. National guidelines for the management of viral encephalitis are needed.</p> http://www.biomedcentral.com/1471-2431/12/145EncephalitisMeningitisCentral nervous system infectionAciclovirLumbar puncture |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kelly Christine Sohal Aman Michael Benedict D Riordan Andrew Solomon Tom Kneen Rachel |
spellingShingle |
Kelly Christine Sohal Aman Michael Benedict D Riordan Andrew Solomon Tom Kneen Rachel Suboptimal management of central nervous system infections in children: a multi-centre retrospective study BMC Pediatrics Encephalitis Meningitis Central nervous system infection Aciclovir Lumbar puncture |
author_facet |
Kelly Christine Sohal Aman Michael Benedict D Riordan Andrew Solomon Tom Kneen Rachel |
author_sort |
Kelly Christine |
title |
Suboptimal management of central nervous system infections in children: a multi-centre retrospective study |
title_short |
Suboptimal management of central nervous system infections in children: a multi-centre retrospective study |
title_full |
Suboptimal management of central nervous system infections in children: a multi-centre retrospective study |
title_fullStr |
Suboptimal management of central nervous system infections in children: a multi-centre retrospective study |
title_full_unstemmed |
Suboptimal management of central nervous system infections in children: a multi-centre retrospective study |
title_sort |
suboptimal management of central nervous system infections in children: a multi-centre retrospective study |
publisher |
BMC |
series |
BMC Pediatrics |
issn |
1471-2431 |
publishDate |
2012-09-01 |
description |
<p>Abstract</p> <p>Objective</p> <p>We aimed to audit the regional management of central nervous system (CNS) infection in children.</p> <p>Methods</p> <p>The study was undertaken in five district general hospitals and one tertiary paediatric hospital in the Mersey region of the UK. Children admitted to hospital with a suspected CNS infection over a three month period were identified. Children were aged between 4 weeks and 16 years old. Details were recorded from the case notes and electronic records. We measured the appropriateness of management pathways as outlined by national and local guidelines.</p> <p>Results</p> <p>Sixty-five children were identified with a median age of 6 months (range 1 month to 15 years). Ten had a CNS infection: 4 aseptic meningitis, 3 purulent meningitis, 3 encephalitis [2 with herpes simplex virus (HSV) type 1]. A lumbar puncture (LP) was attempted in 50 (77%) cases but only 43 had cerebrospinal fluid (CSF) available for analysis. Of these 24 (57%) had a complete standard set of tests performed. Fifty eight (89%) received a third generation cephalosporin. Seventeen (26%) also received aciclovir with no obvious indication in 9 (53%). Only 11 (65%) of those receiving aciclovir had CSF herpes virus PCR. Seventeen had cranial imaging and it was the first management step in 14. Treatment lengths of both antibiotics and aciclovir were highly variable: one child with HSV encephalitis was only treated with aciclovir for 7 days.</p> <p>Conclusions</p> <p>The clinical management of children with suspected CNS infections across the Mersey region is heterogeneous and often sub-optimal, particularly for the investigation and treatment of viral encephalitis. National guidelines for the management of viral encephalitis are needed.</p> |
topic |
Encephalitis Meningitis Central nervous system infection Aciclovir Lumbar puncture |
url |
http://www.biomedcentral.com/1471-2431/12/145 |
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