Çocuklarda Menenjite Güncel Yaklaşım

Çocuklarda pnömokok ve son olarak da meningokok konjü- ge aşıların kullanılmaya başlanmasıyla bakteriyel menenjit daha az görülmektedir. Menenjit, beyni çevreleyen menink- slerin enfeksiyonu olarak tanımlanıp hastaların yaşı küçül- dükçe, menenjit semptom ve bulguları özgüllüğünü kaybet- mektedir. Sütçocuklarında ateş, emmede azalma, huzursuz- luk, çevreyle ilgisizlik gibi silik bulgular gözlenebilmekte- dir. Mevcut semptom ve bulgulara dayanarak bakteriyel menenjit olasılığını öngörmek için Bakteriyel Menenjit Skorlaması gibi modeller geliştirilmiştir. Menenjit şüphesi olan stabil hastalarda, uygun kan testleri yanında kesinlik- le lomber ponksiyon yapılmalıdır. İlk aşamada tam kan sayımı, periferik glukoz, BOS’da lökosit, eritrosit, glukoz, protein tayini ve gram boyama değerlendirilmelidir. Bakteriyel menenjit tedavisine esas olarak zaman kaybet- meden ve toplumdaki antibiyotik duyarlılığına dayanılarak geniş spektrumlu ampirik antibiyotik başlanmalıdır. Antibiyotik tedavisi ne kadar erken başlanırsa sağ kalım üzerine olumlu etkisinin o derece fazla olduğu gösterilmiş- tir. Hâlen menenjit, çocukluk çağının önemli bir morbidite ve mortalite nedeni olup, en riskli gruplar süt çocukları ile adolesanlardır

Anahtar Kelimeler:

Çocuk, menenjit, tedavi

Current Approach to Meningitis in Pediatric Patients

introduction of pneumococcal, and most recently meningo- coccal conjugated vaccines into clinical practice. Menengitis is defined as the infection of the meninges around the brain. The specificity of the symptoms and signs of menengitis is decreased in infants. In infants subtle symptoms like fever, agitation, poor breast feeding and disorientation can be observed. New diagnostic methods based on available symptoms and signs like “Bacterial Menengitis Scoring” system was developed to predict the probability of bacterial menengitis. in stable patients. With suspect menengitis lum- bar punction and appropriate blood tests should be perfor- med. Complete blood count, peripheral blood glucose, leucocyte,erythrocyte, glucose, protein in CSF, should be determined and gram stain should be evaluated at a first step. Treatment of bacterial meningitis should be initiated without delat with broad spectrum antibiotherapy based on antibiotic susceptibility in the community. Studies focus on decreased mortality with the early antimicrobial therapy.At present meningitis is still a major cause of mortality and morbidity in pediatric age group, and infants, and adoles- cents constitute the most risky groups

Keywords:

Child, meningitis, treatment,

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