Hyponatremia in children admitted with acute bacterial meningitis

Mustafa Mahbub1, AZM Mosiul Azam2, Naila Z Khan3

Background : Hyponatremia is a known complication of bacterial meningitis. Various
neurological symptoms may occur with hyponatremia and vary from mild to severe
neurologic dysfunction and requires appropriate management.
Objectives : The aim of this study was to estimate the frequency of hyponatremia
and hypo-osmolality among children admitted with bacterial meningitis and also to
look for their relation with presenting clinical manifestations.
Methods : This prospective study was performed on 40 children for 7 months (from
the August 2002 to February 2003) admitted with bacterial meningitis in Dhaka
Shishu Hospital. Their age range was 1-180 months. Serum electrolytes, glucose,
urea, creatinine, SGPT were estimated and serum osmolality was calculated.
Results : Fourteen of 40 (35%) children had hyponatremia and 20(50%) children had
hypoosmolality. Seizure was present in 33 cases and 11(33.3%) of them were
hyponatremic. Impairment of consciousness was present in 19 children and 7 (36.8%)
of them were hyponatremic. Dehydration was present in 7 children and 5 (71.4%) of
them were hyponatremic.
Conclusion : Hyponatremia is associated with hypo-osmolality which in turn carries
a risk of inducing cerebral edema and neurological manifestations . Serum sodium
should be monitored routinely in all patients with acute bacterial meningitis to enable
early diagnosis and treatment of hyponatremia.

Key words : Hyponatremia, acute bacterial meningitis, hypoosmolality.

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