Cranial computed tomographic scans have little impact on management of bacterial meningitis

I. R. Friedland, M. M. Paris, S. Rinderknecht, G. H. McCracken

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Abstract

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 languageEnglish (US)
Pages (from-to)1484-1487
Number of pages4
JournalAmerican Journal of Diseases of Children
Volume146
Issue number12
Publication statusPublished - 1992

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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