HAEMOPHILUS INFLUENZAE MENINGITIS AT THE ABBASSIA FEVER HOSPITAL 1982 TO 2001

H. influenzae meningitis is a severe disease with high mortality and morbidity rates, and with marked increase in resistance to conventional drugs used for treatment of the disease. The aim of this study was to study the prevalence, clinical presentation, outcome of patients with H influezae meningitis, and to determine the efficacy and safety of new therapeutic regimens that could be used in the treatment of the disease and test the susceptibility of the isolates to the different antibiotics. During the period from January 1982 to December 2001, four hundred and sev- enty two children with H. influenzae meningitis were admitted to the Abbassia Fever Hospital meningitis ward in Cairo. There was no apparent variation in the yearly number of patients admitted to the ward during the period of the study but the number of admissions was much higher during the cold winter months with a peak in the month of February. Early signs and symptoms of H. influenzae meningitis may mimic any febrile disease until frank signs and symptoms of increased intracranial pressure and meningeal irritation become apparent. On admission 65% of the children were in coma, 25% were drowsy and only 10% were alert. During the early phase of the study only a mild percentage of the strains were resistant to penicillin, however with time a marked increase in resistance of the organism to penicillin and chloramphenicol oc- curred. The organism remained very sensitive to the 3rd generation cephalosporins and aztreonam during the period of the study. These drugs were found effective and safe in the treatment of H influezae meningitis. The overall mortality was 30% and of the survivors 22% were left handicapped. The mortality and sequelae were dependant on the duration of the disease prior to initiation of therapy and the state of conscious-