Published Paper Details:

Background: Febrile seizure is the most common type of seizure among the children which may be due to acute bacterial meningitis. Early diagnosis and treatment of acute bacterial meningitis among children with first febrile seizure is utmost necessity. In this study, we evaluated role of cerebrospinal fluid analysis among children with first episode of febrile seizure. Methods: Children aged between 6 to 18 months with first episode of febrile seizure admitted within 24 hr of seizure onset were enrolled. Clinical history, physical findings and vital parameters were noted. Cerebrospinal fluid was analyzed for cell count, sugar, protein, microbiological examination. Acute bacterial meningitis was diagnosed based on cell count>5/mm3, protein >100mg/dl and sugar <40 mg/dl or<50% of serum glucose in the cerebrospinal fluid. Results: Seven (14%) out of 50 children were diagnosed as acute bacterial meningitis. Other causes for febrile seizure were: upper respiratory infection (48%), diarrhea (18%), urinary tract infection (8%) and fever of unknown origin (12%). Three children with acute bacterial meningitis showed positive meningeal sign. In one case of acute bacterial meningitis, organism klebsiella was isolated. Body temperature; hear rate and respiratory rate were found significantly elevated among the cases with acute bacterial meningitis as compared to other cases. Conclusion: In children first febrile seizure, cerebrospinal fluid examination is important to rule out acute bacterial meningitis as the incidence was 14% in this study. Whenever meningeal signs are present with first episode of febrile seizure, there is a significant possibility of acute bacterial meningitis.