Objective. - To assess which clinical features predict an increased likelihood of an abnormal computed tomographic (CT) scan and how frequently CT influences management of bacterial meningitis. Design. - Retrospective patient series. Setting. - University-affiliated hospitals in Dallas, Tex. Patients. - Three hundred thirty-seven children with bacterial meningitis, of whom 107 (32%) had undergone CT scans. Results. - One or more abnormalities were found in 52% of the initial scans. The most frequent indication for CT at our institution was persistent or secondary fever, and in 56% of these children, subdural effusion or empyema was noted. However, findings on CT rarely predicted a need for intervention. In contrast, children with focal seizures or focal neurologic signs were more likely to have brain parenchymal changes. Scans in 19 patients (12%) prompted surgical intervention, most commonly drainage of a subdural collection. The conditions of only nine children (8.4% of those who had undergone CT scans) improved following intervention that was initiated because of findings on CT. Conclusions. - Although CT scans are frequently abnormal in children with meningitis, CT seldom reveals findings that require specific intervention.
|Original language||English (US)|
|Number of pages||4|
|Journal||American Journal of Diseases of Children|
|Publication status||Published - 1992|
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health