Studies on Post-measles Meningitis in Childhood

Abstract

Summary: In a study of 112 post neonatal infants and children admitted with pyogenic meningitis in Maiduguri during the inter-epidemic period, 1992 to 1995 (77 cases) and the meningococcal epidemic of 1966 (35 cases), five (6.5 percent) and two (5.7 percent) respectively, were found to have had antecedent measles infection. Whereas the presenting features were comparable, a significantly (p=0.0077) higher proportion of patients with post-measles meningitis (57.1 percent of seven patients) were misdiagnosed on admission than those without antecedent measles infection (11.4 percent of 105 patients). Also, all the four patients with post-measles meningitis who were misdiagnosed had alternative diagnoses on admission which could have passed as "acceptable" explanations for their clinical conditions. It is concluded that pyogenic meningitis may be an important sequela of measles as shown in the present study. Furthermore, antecedent measles and its complications produced "a red-herring effect"; thus, a high index of suspicion is required to prevent misdiagnosis of an underlying meningitis in children with measles.