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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir nuestra experiencia en el tratamiento extrahospitalario de los ni&#241;os con sospecha de meningitis viral&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Entre abril y julio de 1997&#44; 156 ni&#241;os fueron diagnosticados de meningitis viral en nuestro hospital&#46; De &#233;stos&#44; 150 fueron tratados ambulatoriamente con reposo y analg&#233;sicos&#44; tras permanecer unas horas en la unidad de observaci&#243;n de urgencias&#46; En todos los casos se practic&#243; examen citoqu&#237;mico y tinci&#243;n de Gram del l&#237;quido cefalorraqu&#237;deo &#40;LCR&#41;&#44; hemograma completo y prote&#237;na C reactiva s&#233;rica&#44; hemocultivo y cultivo del LCR para bacterias y virus&#46; La evoluci&#243;n del proceso se control&#243; mediante contacto telef&#243;nico&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Todos los cultivos bacterianos practicados en sangre y LCR fueron negativos y la evoluci&#243;n cl&#237;nica de los pacientes fue favorable&#46; En el control telef&#243;nico posterior 104 ni&#241;os &#40;69&#44;3&#37;&#41; refirieron s&#237;ntomas transitorios como cefalea o molestias radiculares&#46; De &#233;stos &#250;ltimos&#44; 20 ni&#241;os &#40;13&#44;3&#37; de los 150&#41; volvieron a consultar en nuestro servicio de urgencias&#44; por persistencia de los s&#237;ntomas o molestias radiculares&#44; precisando 4 de ellos el ingreso en la unidad de observaci&#243;n durante unas horas &#40;4&#8211;12 h&#41;&#46; Tras el alta de urgencias&#44; los ni&#241;os faltaron al colegio una media de 5&#44;9 &#177; 6&#44;1 d&#237;as &#40;rango&#44; 1&#8211;30 d&#237;as&#41;&#44; y 71 &#40;47&#44;3&#37;&#41; faltaron menos de 3 d&#237;as&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El tratamiento y seguimiento de gran parte de los ni&#241;os con meningitis viral puede hacerse sin necesidad de ingreso hospitalario&#46; En el momento del alta&#44; es preciso dar a la familia instrucciones detalladas sobre la evoluci&#243;n del proceso&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To describe our experience in the extrahospitalary management of children with suspected viral meningitis &#40;VM&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Between April and July 1997&#44; 156 children were diagnosed of VM in our hospital and 150 managed as outpatients&#44; after being a few hours in our emergency department&#46; All of them were suspected to have VM attending usual clinical and laboratory findings and were discharged with cautious instructions to demand a new assessment&#46; We contacted telephonically with them one month and six months later&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">All the children with suspected viral meningitis and managed as outpatients had negative blood and CSF cultures and all of them did well&#46; Telephonically&#44; 104 children &#40;69&#46;3&#37;&#41; referred transient headache or back pain&#44; and 20 of these &#40;13&#46;3&#37; of all the 150&#41; came again to our hospital&#44; and 4 required rest for a few hours &#40;4&#8211;12 hours&#41; in our observation setting&#46; Children with suspected VM didn&#39;t go to school during 5&#46;9 &#177; 6&#46;1 days &#40;1&#8211;30 days&#41; and 71 &#40;47&#46;3&#37;&#41; were absent less than 3 days&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Outpatient management of most of the children with suspected VM is possible&#46; When a patient is sent home&#44; detailed instructions must be given to the family&#46;</p>"
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Vol. 52. Núm. 5.
Páginas 430-434 (mayo 2000)
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Vol. 52. Núm. 5.
Páginas 430-434 (mayo 2000)
Acceso a texto completo
Tratamiento extrahospitalario de los niños con meningitis viral
Outpatient management of children with viral meningitis
Visitas
10178
S. Mintegui Raso**, J. Sánchez Echániz, J. Benito Fernández, M.A. Vázquez Ronco, S. Capapé Zache, I. Goikoetxea Martín
Urgencias de Pediatría. Departamento de Pediatría
G. Rubio Fernández*
* Servicio de Microbiología. Hospital de Cruces. Barakaldo. Bizkaia.
Este artículo ha recibido
Información del artículo
Objetivo

Describir nuestra experiencia en el tratamiento extrahospitalario de los niños con sospecha de meningitis viral.

Pacientes y método

Entre abril y julio de 1997, 156 niños fueron diagnosticados de meningitis viral en nuestro hospital. De éstos, 150 fueron tratados ambulatoriamente con reposo y analgésicos, tras permanecer unas horas en la unidad de observación de urgencias. En todos los casos se practicó examen citoquímico y tinción de Gram del líquido cefalorraquídeo (LCR), hemograma completo y proteína C reactiva sérica, hemocultivo y cultivo del LCR para bacterias y virus. La evolución del proceso se controló mediante contacto telefónico.

Resultados

Todos los cultivos bacterianos practicados en sangre y LCR fueron negativos y la evolución clínica de los pacientes fue favorable. En el control telefónico posterior 104 niños (69,3%) refirieron síntomas transitorios como cefalea o molestias radiculares. De éstos últimos, 20 niños (13,3% de los 150) volvieron a consultar en nuestro servicio de urgencias, por persistencia de los síntomas o molestias radiculares, precisando 4 de ellos el ingreso en la unidad de observación durante unas horas (4–12 h). Tras el alta de urgencias, los niños faltaron al colegio una media de 5,9 ± 6,1 días (rango, 1–30 días), y 71 (47,3%) faltaron menos de 3 días.

Conclusión

El tratamiento y seguimiento de gran parte de los niños con meningitis viral puede hacerse sin necesidad de ingreso hospitalario. En el momento del alta, es preciso dar a la familia instrucciones detalladas sobre la evolución del proceso.

Palabras clave:
Meningitis viral
Niños
Urgencias de pediatría
Tratamiento ambulatorio
Objective

To describe our experience in the extrahospitalary management of children with suspected viral meningitis (VM).

Method

Between April and July 1997, 156 children were diagnosed of VM in our hospital and 150 managed as outpatients, after being a few hours in our emergency department. All of them were suspected to have VM attending usual clinical and laboratory findings and were discharged with cautious instructions to demand a new assessment. We contacted telephonically with them one month and six months later.

Results

All the children with suspected viral meningitis and managed as outpatients had negative blood and CSF cultures and all of them did well. Telephonically, 104 children (69.3%) referred transient headache or back pain, and 20 of these (13.3% of all the 150) came again to our hospital, and 4 required rest for a few hours (4–12 hours) in our observation setting. Children with suspected VM didn't go to school during 5.9 ± 6.1 days (1–30 days) and 71 (47.3%) were absent less than 3 days.

Conclusion

Outpatient management of most of the children with suspected VM is possible. When a patient is sent home, detailed instructions must be given to the family.

Key words:
Viral meningitis
Children
Children emergency room
Outpatient management
El Texto completo está disponible en PDF
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