Characterization of Cerebral Spinal Fluid (CSF) in Bacterial Meningitis in Children at the Albert Royer Children’s Hospital from January 2022 to June 2023 (18 Months) about 62 Cases

Background: Bacterial meningitis is a diagnostic and therapeutic emergency. The aim was to study the cytological, chemical and microbiological characteristics of cerebral spinal fluid (CSF) during bacterial meningitis. Methods: This was a retrospective descriptive and analytical study based on data from patients’ hospitalization records, over the period from January 2022 to June 2023 (18 months). All children aged 0 to 14 years with a CSF study including cytochemistry and/or bacteriology in favor of bacterial meningitis were included. Results: A total of 62 children, with a sex ratio of 1.69, were included. The median age was 22 months, ranging from one day to 126 months. Immunization status was up to date in 85% of patients. Sixteen children (26%) had received antibiotics prior to hospitalization. The most common clinical signs were fever (85%), convulsions (24%), irritability (23%) and altered consciousness (21%). Lumbar puncture was performed on admission in 66% of cases (n = 41). CSF was clear in 58% of patients; cloudy in about 29%. Cytology ranged from 5 to 5040 elements/mm3, with a median of 136 elements/mm3. Glycorrhachia less than 0.4 g/dl was noted in 26% of patients (n = 16), and the median proteinorachy value was 0.77 g/L. Bacteriology was positive in 32.26% of patients (n = 20), with a positivity threshold of 13% (n = 8) for culture versus 20.1% (n = 13) for PCR. Previous antibiotic therapy was associated with negative CSF culture (p = 0.047). Streptococcus pneumoniae was the most frequently found germ (40%; n = 8). Conclusion: The study of CSF is essential for the diagnosis of meningitis. Overuse and inadequate use of antibiotics (prior to sampling) make interpretation difficult.