Clinical presentation, aetiology, course and short term outcome of acute bacterial meningitis in children with and without clinical HIV infection

Abstract

A prospective descriptive study involving 55 patients between 1 - 60 months of age was undertaken at Harare Central Hospital to find out whether there are any differences in the clinical presentation, aetiology and short term outcome of bacterial meningitis in those with clinical HIV infection and those without. Clinical HIV infection was diagnosed in 24 (44%) of the children. There were no apparent differences in the clinical features or aetiology of meningitis. The case fatality rate (CFR) for the study population was 20% of which 45% had clinical HIV infection. The main predictor for mortality was unconsciousness on admission. Seizures occurring before and after admission were a significant risk factor for neurological abnormalities on discharge from hospital. Eight of the 27 (30%) seen on follow up had evidence of neurologic sequelae. Hearing loss was present in 4 of the 15 patients that were tested. Clinical HIV infection was not a risk factor for neurologic sequelae.Children who had clinical HIV infection responded well to the standard treatment given for acute bacterial meningitis and their short term outcome was not different from those without HIV infection.