Article Sidebar

PDF
Issue: Vol. 563 No. 1 (2026)
Section: Các bài báo
DOI: 10.51298/vmj.v563i1.18916
Date Published: 15/09/2026
Views 0
Downloads 0
How to Cite
Phạm, Đ. N., Dương, M. T., & Nguyễn, T. T. (2026). CLINICAL CHARACTERISTICS AND PROGNOSTIC FACTORS OF ACUTE NEUROLOGICAL COMPLICATIONS IN CHILDREN WITH BACTERIAL MENINGITIS AT CHILDREN’S HOSPITAL 1. Vietnam Medical Journal, 563(1). https://doi.org/10.51298/vmj.v563i1.18916

CLINICAL CHARACTERISTICS AND PROGNOSTIC FACTORS OF ACUTE NEUROLOGICAL COMPLICATIONS IN CHILDREN WITH BACTERIAL MENINGITIS AT CHILDREN’S HOSPITAL 1

Đình Nguyên Phạm1, , Minh Toàn Dương1, Thanh Trang Nguyễn1
1 Bệnh viện Nhi đồng 1

Main Article Content

Abstract

Background: Bacterial purulent meningitis remains one of the most severe acute infections of the central nervous system in children, with high global rates of mortality and long-term neurological sequelae. Although several domestic studies have examined epidemiology, antimicrobial resistance, and long-term outcomes, data on in-hospital acute neurological complications and their associated prognostic factors remain limited and have not yet been comprehensively systematized.


Objective: To describe the clinical, laboratory, and microbiological characteristics, and to identify independent prognostic factors associated with acute neurological complications in children with bacterial meningitis.


Methods: A retrospective analytical cohort study was conducted on 80 children aged 1 month to 15 years diagnosed with bacterial meningitis at Children’s Hospital 1 between October 2024 and October 2025. Clinical data, cerebrospinal fluid findings, microbiological results, and in-hospital complications were collected from medical records. Multivariable logistic regression was used to identify independent predictors of acute neurological complications.


Results: The incidence of at least one acute complication was 43.8%, with neurological complications occurring in 40.0% of patients. The most common complications were prolonged or refractory seizures (17.5%), respiratory failure requiring mechanical ventilation (15.0%), and subdural effusion/empyema (12.5%). Streptococcus pneumoniae was the most frequently identified pathogen (18.8%). Multivariable analysis identified three independent predictors of acute neurological complications: admission GCS < 8 (OR = 3.95; 95% CI: 1.65–9.45), S. pneumoniae infection (OR = 4.15; 95% CI: 1.30–12.8), and cerebrospinal fluid protein > 100 mg/dL (OR = 2.55; 95% CI: 1.10–5.90).


Conclusion: Acute complications, particularly neurological complications, are common in pediatric bacterial meningitis. Severe impaired consciousness at admission, pneumococcal etiology, and elevated cerebrospinal fluid protein are important prognostic factors that may facilitate early identification of high-risk patients and guide intensive monitoring and management.

Keywords

Bacterial meningitis, children, acute neurological complications, prognostic factors, Streptococcus pneumoniae, cerebrospinal fluid

Article Details

References

1. Nguyễn, V. L., và c.s. (2025). Đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị viêm màng não mủ tại Bệnh viện Quân y 110 từ tháng 01/2020 đến tháng 12/2024. Tạp chí Y học Quân sự, 379, 52–56. https://doi.org/10.59459/1859-1655/JMM.738
2. Khosravi, A., et al. (2021). The epidemiology and outcomes of meningitis among Iranian children in a period of 10 years. The Open Neurology Journal, 15, 37–45. https://doi.org/10.2174/1874205X02115010037
3. Lempinen, L., Saat, R., Niemelä, S., Laulajainen-Hongisto, A., Aarnisalo, A. A., Nieminen, T., & Jero, J. (2024). Neurological sequelae after childhood bacterial meningitis. European Journal of Pediatrics, 183(12), 5203–5212. https://doi.org/10.1007/s00431-024-05788-w
4. Liu, Y., Feng, Y., Guo, Y., Chen, J., Liu, C., & Liang, J. (2024). Clinical predictors of poor outcome of bacterial meningitis in infants less than 90 days: A systematic review. Frontiers in Pediatrics, 12, 1414778. https://doi.org/10.3389/fped.2024.1414778
5. Truong, H. C., Phan, T. V., Nguyen, H. T., Ho, T. V., Vo, D. T. T., Nguyen, T. V., Nguyen, T. V., & Speybroeck, N. (2025). Clinical features and antibiotic resistance in pediatric pneumococcal meningitis in Southern Vietnam, 2012–2023: A multicenter retrospective study. Journal of Infection and Public Health, 18(7), 102797. https://doi.org/10.1016/j.jiph.2025.102797
6. Truong, H. C., Phan, T. V., Nguyen, H. T., Truong, K. H., Do, V. C., Pham, N. M. N., Ho, T. V., Phan, T. T. Q., Hoang, T. A., Soetewey, A., Ho, T. N. L., Pham, Q. D., Luong, Q. C., Vo, D. T. T., Nguyen, T. V., & Speybroeck, N. (2023). Childhood bacterial meningitis surveillance in Southern Vietnam: Trends and vaccination implications from 2012 to 2021. Open Forum Infectious Diseases, 10(7), ofad229. https://doi.org/10.1093/ofid/ofad229
7. Yang, L., Jin, W., Liu, Y., Hu, W., Chen, Y., Wang, G., Li, W., & Gao, Q. (2026). Recent advancements in pediatric purulent meningitis: Diagnosis and treatment. Italian Journal of Pediatrics, 52(1), 22. https://doi.org/10.1186/s13052-025-02192-4
8. Zainel, A., Mitchell, H., & Sadarangani, M. (2021). Bacterial meningitis in children: Neurological complications, associated risk factors, and prevention. Microorganisms, 9(3), 535. https://doi.org/10.3390/microorganisms9030535