ABSTRACT

The aim of this study is to find out the frequency of acute bacterial meningitis and central nervous system infections in patients presenting themselves to pediatric children emergency unit due to first febrile seizure.

In this study 85 children aged 6-60 months of old admitted to pediatric emergency unit from January 1, 2011 to January 1, 2012 were evaluated retrospectively. Performing of the lumber puncture rate was compared in regard to age groups (between ≤12 months and >12 months) seizure types (simple and complex).

The median age was 23 months (interquartile range: 18) and 64.7% were male and 35.3% were female. Of the patients, 81.2% were for simple febrile seizures and 18.8% were for complex febrile seizures. Blood cultures were performed in 10.6% of patients, cerebrospinal fluid cultures in 10.6%. The rate of lumber puncture were higher among children under 12 months of age and who presented with complex febrile seizure (p=0.003 and p=0.003 respectively). Two patients who younger than 12 months had cerebrospinal fluid pleocytosis but none of the cerebrospinal fluid and/or blood cultures yielded bacterial pathogens and no patient was diagnosed as having bacterial meningitis. 75.3% of the patients were discharged from the emergency department. None of them subsequently returned to the hospital with clinical detoriation or serious bacterial infection within 10 days.

The risk of acute bacterial meningitis is very low in patients with first febrile seizure in the absence of any initial clinical and laboratory evidence. But, patients who younger than 12 months or deficient vaccination status should be strongly considered to perform of the lumber puncture if there is any suspicion. While acknowledging the limitations of number of cases of the study, it may be argued that taking the clinical situation of the patient, lumber punction should be considered for patients with complex febrile seizures as well as for simple types.

Keywords: Febrile seizure, lumber puncture, meningitis