Table 3.
Presenting features of 284 hospitalised children meeting the clinical case definition for CNS infection
| Clinical feature | 1-11 m | 1-4y | 5-15y | Overall | P-value |
|---|---|---|---|---|---|
| (n = 68) | (n = 108) | (n = 108) | (n = 284) | ||
| History | |||||
| Symptom duration (days), median (range) | 4 (1–30) | 3 (1–50) | 5 (1–30) | 4 (1–50) | <0.0001 |
| Fever, n (%) | 68 (100) | 108 (100) | 108 (100) | 284 (100) | – |
| Respiratory symptomsa, n (%) | 49 (72.1) | 61 (56.5) | 37/107 (34.6) | 147/283 (51.9) | <0.0001 |
| Vomiting, n (%) | 33 (48.5) | 37 (34.3) | 81 (75.0) | 151 (53.2) | <0.0001 |
| Diarrhoea, n (%) | 25 (36.8) | 30 (27.8) | 18 (16.7) | 73 (25.7) | 0.002 |
| Reduced feeding / eating & drinking, n (%) | 40 (58.8) | 62/105 (59.0) | 73 (67.7) | 175/281 (62.3) | 0.0007 |
| Lethargicb, n (%) | 34/66 (51.5) | 45/102 (44.1) | 63/107 (58.9) | 142/275 (51.6) | 0.2 |
| Headache, n (%) | NA | NA | 100/107 (93.5) | – | – |
| Photophobia, n (%) | NA | NA | 9/104 (8.7) | – | – |
| Seizures, n (%) | 47 (69.1) | 86 (79.6) | 18 (16.7) | 151 (53.2) | <0.0001 |
| Generalised seizure | 43 (63.2) | 79 (73.1) | 16 (14.8) | 138 (48.6) | – |
| Focal seizure | 4 (5.9) | 6 (5.6) | 2 (1.9) | 12 (4.2) | – |
| Unknown seizure type | 0 (0) | 1 (0.9) | 0 (0) | 1 (0.4) | – |
| Medication in week prior to admission, n (%) | 21 (30.9) | 39/104 (37.5) | 70 (64.8) | 130/280 (46.4) | 0.003 |
| Antibiotic c | 6 (8.8) | 7/104 (6.7) | 11 (10.2) | 24/280 (8.6) | – |
| Unknown medication | 15 (22.1) | 32/104 (30.8) | 59 (54.6) | 106/280 (37.9) | – |
| Physical findings | |||||
| Temperature (°C), median (range) | 38.7 (36.5–40.3) |
39.0 (38.0–40.8) |
38.7 (38.0–42.0) |
38.9 (36.5–39.4) |
0.3 |
| Reduced conscious leveld, n (%) | 3/50 (6.0) | 12/89 (13.5) | 11/104 (10.6) | 26/243 (10.7) | 0.5 |
| Bulging anterior fontanelle, n (%) | 17/64 (26.6) | NA | NA | NA | – |
| Neck stiffness / positive Kernig’s sign, n (%) | 6/64 (9.4) | 6/93 (6.5) | 31/98 (31.6) | 43/255 (16.9) | 0.01 |
| Limb weakness, n (%) | 2 (2.9) | 1 (0.9) | 11 (10.2) | 14/284 (4.9) | 0.01 |
| Rash, n (%) | 5/66 (7.6) | 2/102 (0.02) | 3/102 (2.9) | 10/270 | 0.2 |
NA not age applicable
aAny of: cough, dyspnoea, rhinorrhoea, earache
bDifficult to wake up or more sleepy than normal
cAmoxicillin (14); ceftriaxone (5); ampicillin (2); ciprofloxacin (2); ceftriaxone + gentamicin (1)
dAdmission GCS < 15/15 or V, P, or U on AVPU scale