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Journal of Tropical Pediatrics 1998 44(3):167-168; doi:10.1093/tropej/44.3.167
© 1998 by Oxford University Press
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brief-report

Indications and Benefits of Computed Tomography in Childhood Bacterial Meningitis

Azhar S. Daoud, FRCP, Professor of Pediatrics*,, Hamzi Omari, FRCR, Assistant Professor of Radiology**, Mahmoud Al-Sheyyab, MRCPI, Associate Professor of Pediatrics* and Faisal Abuekteish, MRCP, Assistant Professor of Pediatrics*

*Department of Pediatrics, Jordan University of Science & Technology Irbid, Jordan
**Department of Radiology, Jordan University of Science & Technology Irbid, Jordan

Professor Azhar Daoud, FRCP, Department of Pediatrics, Faculty of Medicine, Jordan University of Science & Technology, PO Box 3030, Irbid, Jordan. Fax 962 2 278 119

Over a 5 year period, 58 children with acute bacterial meningitis underwent computed tomography (CT) of the head. The major stated indications were partial, complex, or prolonged seizures in children younger than 5 years (60 per cent) and prolonged fever in the case of those older than 5 years (60 per cent). Abnormal findings on CT scan were seen in 27 (47 per cent); the remaining 31 (53 per cent) patients had normal or only non-specific dilatation of spaces containing cerebrospinal fluid (CSF) or basilar enhancement. The commonest CT abnormalities were seen in those patients who presented with complex seizure disorders. The commonest abnormal findings were subdural collection (33 per cent) followed by hydrocephalus (7 per cent). Subdural collection was seen mainly in patients with Haemophilus influenzae bacterial meningitis (90 per cent) while hydrocephalus was mainly seen in tuberculous meningitis. Positive finding of obvious therapeutic clinical relevance were present in only six cases (10 per cent). From this study we concluded that head CT provides an accurate means of diagnosing intracranial complications of bacterial meningitis, but it must be used conservatively as it has limited therapeutic applications in children with complicated bacterial meningitis. Computed tomography is indicated mainly in children with persistent neurologic dysfunction like complex seizure disorder, and is of little value in children with prolonged fever alone.


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