Cerebrovascular lesions in children with purulent meningitis

Abstract

Purulent meningitis in children is a severe disease characterized by high mortality, particularly in case of pneumococcal infection. Cerebrovascular lesions in purulent meningitis are one of the most important pathogenic factors that determine the course of the disease. The severity of vascular lesions (including those to cerebral vessels) in bacterial infection depends on patient’s age and disease severity, which is associated with its etiology. Objective. To characterize cerebrovascular disorders in children with purulent meningitis and assess their association with the disease etiology and severity. Patients and methods. This study included 80 children aged 1 month to 17 years and 11 months with purulent meningitis caused by different pathogens and confirmed cerebrovascular lesions. In addition to clinical monitoring, all patients have undergone blood clotting tests (including platelet count, prothrombin, fibrinogen, activated partial thromboplastin time, and thrombin time), and assessment of D-dimer and level of circulating endothelial cells during the disease. Results. We observed various lesions to vessels in children with purulent meningitis, which is attributed to both structural and functional impairments in the vessel wall, as well as to an impaired vasomotor function of the endothelium. Conclusion. We found that cytoflavin, a drug with a multimodal action (including endothelium protection), was effective for the treatment of purulent meningitis. Key words: children, purulent meningitis, cerebrovascular disorders, vasculitis, D-dimer, circulating endothelial cells, cytoflavin