Meningitis neumocócica en la infancia. Revisión de 28 casos
Pneumococcal meningitis in children. review of 28 cases
Servicio de Cuidados Intensivos Pediátricos. Hospital Universitario del Niño Jesús.Universidad Autónoma de Madrid.
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Bergadá, J.J. Heinrich" "autores" => array:2 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Bergadá" ] 1 => array:2 [ "nombre" => "J.J." "apellidos" => "Heinrich" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403300774248?idApp=UINPBA00005H" "url" => "/16954033/0000005300000002/v1_201307051512/S1695403300774248/v1_201307051512/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1695403300774224" "issn" => "16954033" "doi" => "10.1016/S1695-4033(00)77422-4" "estado" => "S300" "fechaPublicacion" => "2000-08-01" "aid" => "77422" "copyright" => "Asociación Española de Pediatría" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "edi" "cita" => "An Pediatr (Barc). 2000;53:91-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2627 "formatos" => array:3 [ "EPUB" => 49 "HTML" => 1922 "PDF" => 656 ] ] "es" => array:6 [ "idiomaDefecto" => true "titulo" => "La columna del Editor" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "91" "paginaFinal" => "93" ] ] "contienePdf" => array:1 [ "es" => true ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403300774224?idApp=UINPBA00005H" "url" => "/16954033/0000005300000002/v1_201307051512/S1695403300774224/v1_201307051512/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Meningitis neumocócica en la infancia. Revisión de 28 casos" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "94" "paginaFinal" => "99" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Mencía Bartolomé, J. Casado Flores, C. Marín Barba, M. González-Vicent, M.J. Ruiz López" "autores" => array:5 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Mencía Bartolomé" ] 1 => array:3 [ "nombre" => "J." "apellidos" => "Casado Flores" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Marín Barba" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "González-Vicent" ] 4 => array:2 [ "nombre" => "M.J." "apellidos" => "Ruiz López" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cuidados Intensivos Pediátricos. Hospital Universitario del Niño Jesús.Universidad Autónoma de Madrid." ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Servicio de Cuidados Intensivos Pediátricos.Hospital del Niño Jesús. Av. Menendez Pelayo, 65. 28009. Madrid." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pneumococcal meningitis in children. review of 28 cases" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-08-31" "fechaAceptado" => "2000-05-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186417" "palabras" => array:6 [ 0 => "Meningitis" 1 => "S" 2 => "pneumoniae" 3 => "Sordera" 4 => "Coma" 5 => "Pediatría" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186418" "palabras" => array:6 [ 0 => "Meningitis" 1 => "S" 2 => "pneumoniae" 3 => "Deafness" 4 => "Coma" 5 => "Children" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir las características epidemiológicas, clínicas y los indicadores pronóstico de las meningitis neumocóci-cas ingresadas en un hospital pediátrico de Madrid.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de 28 niños que ingresaron en el hospital por meningitis neumocócica diagnosticados mediante la identificación de Streptococcus pneumoniae en sangre o LCR, en el período comprendido entre 1990 y 1999. Se analizaron variables relacionadas con la evolu-ción. Ningún paciente tenía déficit inmunológico previo, ninguno había recibido vacuna antineumocócica.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La edad de los pacientes fue 2,7 ± 2,9 años (rango de 2 meses a 11 años). El 82% (23 casos) de los niños eran menores de 5 años. La relación niño-niña fue de 1:1. Los signos más frecuentes al ingreso fueron fiebre (100%), vómitos (57%), cefalea-irritabilidad (53%) y alteraciones hemo-dinámicas (10%). Los hallazgos neurológicos fueron: disminución del nivel de conciencia en 22 casos (escala de coma de Glasgow medio de 9,9 ± 3,9); convulsiones en 15 casos (53%); signos meníngeos positivos en 12 casos (42%) y midriasis arreactiva en 9 casos (32%). Precisaron ingreso en la unidad de cuidados intensivos 20 pacientes (71%). Al alta no presentaban secuelas 15 casos (53%); sordera 8 casos (28%); hemiparesia 4 casos (14%); hidrocefalia intensa 2 casos (7%), y retraso mental un caso (3,5%). Cuatro pacientes (14%) fallecieron. La baja puntuación en la escala de coma de Glasgow al ingreso y la TC craneal alterada se asociaron de forma significativa a mayor mortalidad y sordera (p < 0,05). La presencia de convulsiones, el electroencefalograma (EEG) alterado y la hipoglucorraquia también se asociaron a la sordera (p < 0,05).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las meningitis producidas por Streptococcus pneumo-niae tienen una alta morbimortalidad en la infancia. La sordera neurosensorial es la secuela más frecuente secundaria a esta patología. La baja puntuación en la escala de coma de Glasgow al ingreso, la TC y el EEG alterados, así como las convulsiones y la hipoglucorraquia se relacionaron con un peor pronóstico. La nueva vacuna conjugada antineumocócica permitirá una prevención eficaz desde los dos meses de edad y el descenso drástico de esta grave infección.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To describe the epidemiological characteristics, clinical features and prognostic indicators of pneumococcal meningitis in children admitted to a children's hospital in Madrid.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We retrospectively studied 28 children with a diagnosis of pneumococcal meningitis based on identification of S. pneumoniae in the blood or cerebrospinal fluid between 1990 and 1999. None of the children had previous immunological deficit or had received antipneumococ-cal vaccine.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The mean age of patients was 2.7 ± 2.9 years (range: 2 months to 11 years). Eighty-two percent of the children were younger than 5 years old. Male to female ratio was 1:1. The most frequent signs on admission were fever (100%), vomiting (57%), headache and irritability (53%), and shock (10%). Neurologic findings were lowered level of consciousness in 22 patients (mean Glasgow Coma Scale score 9.9 ± 3.9); seizures in 15 (53%); neck stiffness in 12 patients (42%) and arreactive mydriasis in 9 patients (32%). Twenty patients (71%) required admission to the intensive care unit. On discharge 15 patients (53%) had no sequelae; 8 patients (28%) suffered deafness; 4 (14%) had hemiparesis; 2 (7%) had severe hydrocephalus and 1 patient (3.5%) had mental retardation. Four patients (14%) died. Findings with the strongest predictive value for death or deafness (p > 0.05) were coma and alterations in cranial computer tomography (CT). Seizures, alterations in electroencephalogram (EEG) and hypogly-corrhachia were also prognostic indicators for deafness (p < 0.05).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Meningitis caused by S. pneumoniae is a significant cause of morbidity and mortality in children. Deafness is one of the most common and serious sequelae of pneu-mococcal meningitis. Sequelae were asociated with coma, alterations in CT scan, seizures and hypoglycorrhachia. The new, antipneumococcal conjugated vaccine will confer effective prevention from the age of 2 months and will produce a dramatic decrease in the incidence of this serious infection.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid disappearence of Haemophilus influenzaetype b meningitis after routine child-hood immunisation with conjugate vaccines." "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Peltola" 1 => "T. Kilpi" 2 => "M. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 7 | 16 | 23 |
| 2024 Octubre | 59 | 40 | 99 |
| 2024 Septiembre | 56 | 36 | 92 |
| 2024 Agosto | 84 | 74 | 158 |
| 2024 Julio | 53 | 40 | 93 |
| 2024 Junio | 86 | 31 | 117 |
| 2024 Mayo | 66 | 48 | 114 |
| 2024 Abril | 70 | 26 | 96 |
| 2024 Marzo | 55 | 42 | 97 |
| 2024 Febrero | 52 | 56 | 108 |
| 2024 Enero | 63 | 33 | 96 |
| 2023 Diciembre | 89 | 25 | 114 |
| 2023 Noviembre | 74 | 49 | 123 |
| 2023 Octubre | 88 | 30 | 118 |
| 2023 Septiembre | 46 | 26 | 72 |
| 2023 Agosto | 45 | 29 | 74 |
| 2023 Julio | 65 | 39 | 104 |
| 2023 Junio | 82 | 31 | 113 |
| 2023 Mayo | 74 | 22 | 96 |
| 2023 Abril | 53 | 22 | 75 |
| 2023 Marzo | 55 | 27 | 82 |
| 2023 Febrero | 47 | 26 | 73 |
| 2023 Enero | 61 | 39 | 100 |
| 2022 Diciembre | 78 | 33 | 111 |
| 2022 Noviembre | 85 | 51 | 136 |
| 2022 Octubre | 45 | 42 | 87 |
| 2022 Septiembre | 68 | 39 | 107 |
| 2022 Agosto | 80 | 53 | 133 |
| 2022 Julio | 75 | 47 | 122 |
| 2022 Junio | 97 | 49 | 146 |
| 2022 Mayo | 73 | 40 | 113 |
| 2022 Abril | 64 | 54 | 118 |
| 2022 Marzo | 63 | 51 | 114 |
| 2022 Febrero | 48 | 33 | 81 |
| 2022 Enero | 59 | 44 | 103 |
| 2021 Diciembre | 56 | 50 | 106 |
| 2021 Noviembre | 92 | 48 | 140 |
| 2021 Octubre | 106 | 76 | 182 |
| 2021 Septiembre | 55 | 44 | 99 |
| 2021 Agosto | 67 | 49 | 116 |
| 2021 Julio | 70 | 51 | 121 |
| 2021 Junio | 99 | 73 | 172 |
| 2021 Mayo | 76 | 34 | 110 |
| 2021 Abril | 204 | 111 | 315 |
| 2021 Marzo | 155 | 41 | 196 |
| 2021 Febrero | 119 | 41 | 160 |
| 2021 Enero | 114 | 33 | 147 |
| 2020 Diciembre | 116 | 29 | 145 |
| 2020 Noviembre | 84 | 21 | 105 |
| 2020 Octubre | 129 | 23 | 152 |
| 2020 Septiembre | 91 | 21 | 112 |
| 2020 Agosto | 77 | 9 | 86 |
| 2020 Julio | 77 | 30 | 107 |
| 2020 Junio | 67 | 21 | 88 |
| 2020 Mayo | 71 | 25 | 96 |
| 2020 Abril | 34 | 21 | 55 |
| 2020 Marzo | 66 | 28 | 94 |
| 2020 Febrero | 56 | 24 | 80 |
| 2020 Enero | 62 | 33 | 95 |
| 2019 Diciembre | 88 | 40 | 128 |
| 2019 Noviembre | 140 | 15 | 155 |
| 2019 Octubre | 80 | 17 | 97 |
| 2019 Septiembre | 74 | 48 | 122 |
| 2019 Agosto | 70 | 33 | 103 |
| 2019 Julio | 92 | 36 | 128 |
| 2019 Junio | 85 | 35 | 120 |
| 2019 Mayo | 115 | 60 | 175 |
| 2019 Abril | 132 | 70 | 202 |
| 2019 Marzo | 75 | 31 | 106 |
| 2019 Febrero | 98 | 39 | 137 |
| 2019 Enero | 66 | 30 | 96 |
| 2018 Diciembre | 56 | 35 | 91 |
| 2018 Noviembre | 75 | 39 | 114 |
| 2018 Octubre | 81 | 29 | 110 |
| 2018 Septiembre | 47 | 22 | 69 |
| 2018 Julio | 2 | 0 | 2 |
| 2018 Junio | 1 | 0 | 1 |
| 2018 Mayo | 7 | 0 | 7 |
| 2018 Abril | 39 | 0 | 39 |
| 2018 Marzo | 26 | 0 | 26 |
| 2018 Febrero | 21 | 1 | 22 |
| 2018 Enero | 31 | 0 | 31 |
| 2017 Diciembre | 39 | 0 | 39 |
| 2017 Noviembre | 29 | 0 | 29 |
| 2017 Octubre | 25 | 0 | 25 |
| 2017 Septiembre | 16 | 0 | 16 |
| 2017 Agosto | 26 | 0 | 26 |
| 2017 Julio | 23 | 0 | 23 |
| 2017 Junio | 35 | 10 | 45 |
| 2017 Mayo | 32 | 9 | 41 |
| 2017 Abril | 30 | 11 | 41 |
| 2017 Marzo | 28 | 11 | 39 |
| 2017 Febrero | 13 | 5 | 18 |
| 2017 Enero | 24 | 2 | 26 |
| 2016 Diciembre | 36 | 10 | 46 |
| 2016 Noviembre | 58 | 6 | 64 |
| 2016 Octubre | 72 | 7 | 79 |
| 2016 Septiembre | 62 | 20 | 82 |
| 2016 Agosto | 61 | 18 | 79 |
| 2016 Julio | 41 | 16 | 57 |
| 2016 Febrero | 2 | 0 | 2 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Septiembre | 1 | 21 | 22 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 7 | 6 | 13 |
| 2015 Junio | 12 | 0 | 12 |
| 2015 Mayo | 10 | 5 | 15 |
| 2015 Abril | 7 | 0 | 7 |
| 2015 Marzo | 4 | 0 | 4 |
| 2015 Febrero | 1 | 0 | 1 |
| 2015 Enero | 11 | 0 | 11 |
| 2014 Diciembre | 10 | 1 | 11 |
| 2014 Noviembre | 9 | 0 | 9 |
| 2014 Octubre | 12 | 1 | 13 |
| 2014 Septiembre | 9 | 2 | 11 |
| 2014 Agosto | 13 | 2 | 15 |
| 2014 Julio | 17 | 1 | 18 |
| 2014 Junio | 26 | 3 | 29 |
| 2014 Mayo | 20 | 1 | 21 |
| 2014 Abril | 18 | 4 | 22 |
| 2014 Marzo | 26 | 6 | 32 |
| 2014 Febrero | 15 | 6 | 21 |
| 2014 Enero | 14 | 9 | 23 |
| 2013 Diciembre | 24 | 10 | 34 |
| 2013 Noviembre | 17 | 5 | 22 |
| 2013 Octubre | 27 | 4 | 31 |
| 2013 Septiembre | 21 | 7 | 28 |
| 2013 Agosto | 13 | 4 | 17 |
| 2013 Julio | 4 | 3 | 7 |
| 2013 Junio | 1 | 3 | 4 |
| 2013 Mayo | 3 | 1 | 4 |
| 2013 Abril | 3 | 1 | 4 |
| 2013 Marzo | 4 | 4 | 8 |
| 2013 Febrero | 15 | 2 | 17 |
| 2013 Enero | 15 | 6 | 21 |
| 2012 Diciembre | 8 | 2 | 10 |
| 2012 Noviembre | 9 | 3 | 12 |
| 2012 Octubre | 4 | 1 | 5 |
| 2012 Septiembre | 7 | 2 | 9 |
| 2012 Agosto | 1 | 1 | 2 |
| 2000 Julio | 2539 | 0 | 2539 |
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