Prevalence of meningitis in newborns with fever in a third-level hospital center: Meningitis in febrile newborns

Abstract

Introduction: Meningitis is an acute inflammatory process of the central nervous system caused by microorganisms affecting the leptomeninges. Cerebrospinal fluid examination should be performed in febrile newborns because of the high risk of meningitis. Objective: The objective of the study was to determine the prevalence of meningitis in febrile newborns at the “Dr. José Eleuterio González” Hospital Universitario. Materials and methods: An observational, descriptive, and retrospective study of neonates admitted to the neonatal intensive care unit with fever. The sample was divided into two groups: Group A (fever/meningitis) and Group B (fever/no meningitis) from January to December 2019. We analyzed maternal and neonatal variables, and cerebrospinal fluid (CSF) biochemical variables, as well as CSF and blood cultures. Results: Sixty-five neonates with fever were included, 37 in Group A and 28 in Group B. In the group with meningitis, we found premature rupture of membranes (PROM) to be 18.9%, with the latency time between rupture and birth being 0.0 (0-120) h (p = 0.03). Regarding the statistically significant variables in the CSF, we found pleocytosis 25 (0-725) cells/mm3, elevated CSF proteins 106 (0-478) mg/dl, and lactate 2 (0-0-4.9) mmol/L (p = 0.049). The percentage of bacterial isolation in the meningitis group was 13.5%. Conclusions: The prevalence of meningitis in febrile newborns was 57%, the main risk factor was PROM. Pleocytosis, elevated CSF proteins, and lactate were statistically significant values for diagnosis. The percentage of bacterial isolation in CSF was 13.5%. The mortality was 0%.

Keywords

• Cerebrospinal fluid. Meningitis. Febrile newborn.