Prevalence of Meningitis in First Episode of Febrile Seizure in Children Aged between 6 to 18 Months: A Cross-sectional Study.

Introduction: Febrile Seizures (FS) are the most common type of childhood seizures, affecting 2-5% of children older than one month and most commonly from six months to 5-year-old. It is a major cause of paediatric admissions worldwide. In India, American Academy of Paediatrics (AAP) 2010 guidelines are followed for performing Lumbar Puncture (LP) in first episode of FS, despite the fact that epidemiological differences exist between the two countries. The present study has been done to find out whether AAP guidelines are applicable in India. Aim: To find out the prevalence and predictors of meningitis in first episode of FS in children aged 6-18 months. Materials and Methods: This was a cross-sectional study carried out in 200 children, aged between 6-18 months admitted with first episode of FS in Paediatric Ward of tertiary care hospital New Delhi, India, over a period of 18 months (May 2018 to December 2019). The LP was performed and blood, Cerebrospinal Fluid (CSF), clinical parameters were analysed using Statistical Package for the Social Sciences (SPSS) version 21.0. Results: The prevalence of meningitis in children aged 6-18 months presenting with first episode of FS was 16% (n=32). Bacterial Meningitis (BM) was seen in 3% (n=6) of cases. The independent predictors of meningitis were high Total Leucocyte Count (TLC) (>16500 cells/mm3) and positive C-Reactive Protein (CRP). Blood culture was positive in seven cases (three cases of Streptococcus pneumoniae, two MRSA, one each Klebsiella pneumoniae and Neisseria meningitidis). Most common type of cell seen was monocytes which was alone seen in 56.2% (n=18) of the meningitis cases. Conclusion: India should have its own guidelines for performing LP in cases of first episode of FS as the prevalence of meningitis in children with first episode of FS in India is more than in the USA, and immunisation coverage for Haemophilus and Pneumococcal Vaccine (PCV) is very less as compared to USA. Meningitis can be predicted in those with high TLC (16500 cells/mm³) and CRP positive. [ABSTRACT FROM AUTHOR]