Background. Neonatal meningitis (NM) is a major cause of neonatal mortality and neurological complications, emphasizing the need for early diagnosis and timely treatment. Prompt intervention is essential to reducing mortality and preventing long-term impairments.
The objective of the study was to compare the clinical, paraclinical, and outcome between early-onset (EOM) and late-onset (LOM) neonatal meningitis.
Materials and methods. A retrospective study was conducted at Can Tho Children’s Hospital, Vietnam, from 2021 to 2023. Infants with symptoms within the first 72 hours of life were classified as EOM, while those presenting after 72 hours were categorized as LOM. The statistical analysis was carried out using Chi-square test and t-test. A p-value < 0.05 was considered statistically significant.
Results. Ninety-eight full-term NM infants were included, 62 male (63.3%), with a median age of 10 days (2-22 days). EOM was diagnosed in 32 (32.7%) infants, while 66 (67.3%) had LOM. Fever was more common in EOM than LOM (81.8% vs 56.2%, p=0.02). Jaundice was significantly higher in EOM (59.4% vs 28.8%, p=0.004), as were seizures (28.1% vs 13.6%, p=0.09). Elevated C-reactive protein (CRP) was more frequent in EOM (71.9% vs 40.9%, p=0.004), indicating a stronger inflammatory response. Cerebrospinal fluid (CSF) protein levels were also higher in EOM (81.2% vs 51.5%, p=0.007), suggesting more severe disease. Recovery rates were 84.3% in EOM and 91% in LOM.
Conclusions. EOM presents with more severe clinical features and higher complication rates than LOM, despite high recovery rates in both groups. These findings highlight the importance of early diagnosis and treatment to improve neonatal outcomes and reduce long-term neurological sequelae.
Keywords: meningitis, cerebrospinal fluid, neonate, infection.
Email to Author
Address for correspondence:
Duc Long TRAN
Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City 90000, Vietnam
email: tdlong@ctump.edu.vn
