Chirag Saluja
Safdarjung Hospital, India
Posters & Accepted Abstracts: Qual Prim Care
Background: Febrile seizures (FS) are the most common type of childhood seizures, affecting 2-5% of children older than one month and most commonly from six months to five years old. It is a major cause of Pediatric admissions worldwide. In India, AAP 2010 guidelines are followed for performing Lumbar Puncture (LP) in first episode of febrile seizure despite India having wide difference in the epidemiology of Meningitis and immunisation coverage as compared to USA. This study has been done to find out whether AAP guidelines are applicable in India also or there is a need for our own guidelines.
Aims & Objectives: Primary objective is to find out the prevalence of Meningitis in first episode of febrile seizure in children aged 6 to 18 months. Secondary objective is to find out predictors of Meningitis in children with first episode of febrile seizure.
Materials & Methods: A cross-sectional study over a period of 18 months was carried out in Pediatric wards of Safdarjung Hospital. LP was performed and results analysed for Meningitis as per guidelines.
Results: 200 cases were analysed. The prevalence of Meningitis in children aged 6 to 18 months presenting with first episode of febrile seizure was 16%. Bacterial Meningitis was seen in 3%. The independent predictors of Meningitis were high TLC(>16500/mm3), positive CRP and prematurity. High grade fever (>102Ã?Â?F), high seizure duration (>12 minutes), low MCV(<75fl), malnutrition(lesser weight for age) and longer post ictal state duration(>14 minutes) were seen as predictors of Meningitis but after logistic regression they were not found to be independent predictors. Streptococcus pneumoniae was the most common organism isolated in the blood (42.8%) as well as the CSF (50%) of the cases taken. Most common type of cell seen was monocytes which were alone seen in 56.2% of the Meningitis cases.
Conclusion: India needs its own guidelines for performing LP in cases of first episode of FS. Meningitis can be predicted in those with high TLC (16500/mm3), CRP positive and who are prematurely born.
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