Cerebrospinal Fluid Findings in Septicaemic Newborns

Abstract

Background: Meningitis is a serious problem in newborn infants and causes frequent neurological sequel in servicing patient. About 20%-30% of neonatal septicaemia whether early or late, is complicated by bacterial meningitis. Methods: This is a prospective study conducted from September 2006 to February 2007 among septicaemic babies in Sir Salimullah Medical College and Mitford Hospital. This study was conducted to see the cerebrospinal fluid findings in 51 septicemic newborns. Purposive sampling method was used for collecting the sample. Results: The age of the respondents ranged from 10 days to 28 days. Most of the respondents were of age group 10-20 years. The mean age of the respondents was 15.43 days and weight was 2.78 kg with a standard deviation (±) 0.56 kg. Among the respondents 55% were male and 45% were female. Maternal fever had a great role in developing neonatal septicaemia. Among 51 septicemic babies 76.5% had only septicemia (39 patients) and 23.5% (12 patients) had septicemia with meningitis. Out of 12 meningitic babies 33.3% were preterm and 58.3% were term and 8.3% were post term. Regarding place of delivery 8 (66.7%) were born at home. Anterior fontanel was full in 12.8% of meningitic babies. 79.5% of septicaemic and 83.3% of meningitic babies had lethargy (p value -0.637), the P value for fever was 0.58 and abdominal distention was 0.522, these differences were not statistically significant. Septicaemic newborns had higher levels (48.2821±64.6952) of C reactive protein. Mean CSF protein was 315.04 mg/dl with a standard deviation 87.87 in case of meningitic babies and 53.66±18.72 in case of septicaemic babies. Out of 51 patients total 05 patients were culture positive. 03cases were blood culture positive (02 cases E. Coli &01 salmonella sup.), 01 case was CSF culture positive (Streptococcus viridians) and 01 case was umbilical swab culture positive (Klebsella). In case of meningitis mortality rate (16.7%) was higher than septicemia (12.8%). Conclusion: Reviewing the overall findings there was no significant difference between signs and symptoms but mortality rate was higher in case of meningitis.