Convulsions With Fever as a Presenting Feature of Bacterial Meningitis Among Preschool Children in Developing Countries

The authors report 522 infants and young children aged between one month and six years who presented with convulsions and fever as emergencies in Nigeria. 22 had bacterial meningitis, six of whom lacked the usual signs of meningitis. Although features of complex febrile convulsions were significantly associated with bacterial meningitis, it is concluded that, as an aid to the early diagnosis of bacterial meningitis, all preschool children convulsing with fever in developing countries should have a lumbar puncture. This may reduce the contribution of meningitis to chronic neurological disabilities. The necessity for such a policy is illustrated by a case report of a young infant with convulsions and fever caused by meningitis, seen at a general hospital.