Evaluation of Pediatric Patients Admitted to the Pediatric Intensive Care Unit with Suspected Central Nervous System Infections

Objective: Central nervous system (CNS) infections, including meningitis and encephalitis, are rare but critical causes of morbidity and mortality, where rapid diagnosis is essential. This study aimed to investigate theclinical and epidemiological characteristics of patients admitted to the pediatric intensive care unit (PICU) with suspected CNS infections.Methods: This retrospective study included all children aged 1 month to 18 years who were admitted to the PICU at Bağcılar Training and Research Hospital with suspected CNS infections between July 2020 and July 2024.Results: A total of 95 patients with suspected CNS infections were included in the study, of whom 61.1% were male. Chronic comorbidities were present in 58% of the patients, with neurological disorders being the most common. CNS infections were confirmed in 37.9% (36/95) of the cases. Among those with confirmed CNS infections, ventriculoperitoneal shunt (VPS) infections accounted for 47.2%, bacterial meningitis for 41.7%, herpes simplex virus (HSV) encephalitis for 5.6%, and other viral encephalitis for 5.6%. The overall mortality rate was 23.2% (22/95). Furthermore, the initial Pediatric Glasgow Coma Score (pGCS) demonstrated a strong predictive value for mortality in the ROC analysis (AUC: 0.828, P < .001), showing better predictive ability than the Pediatric Risk of Mortality III score.Conclusions: CNS infections remain a significant cause of mortality in children. VPS infections, particularly in patients with predisposing neurological conditions, have emerged as a notable etiology of CNS infections in PICUs. Additionally, it is proposed that the initial pGCS score serves as a reliable predictor of mortality in patients with suspected CNS infections.Cite this article as: Özel A, Yüce S, Şengenç E, et al. Evaluation of pediatric patients admitted to the pediatric intensive care unit with suspected central nervous system infections. Cerrahpaşa Med J. 2025, 49, 0004, doi: 10.5152/cjm.2025.25004.