Evaluation of Aseptic Meningitis Following Measles-Mumps-Rubella Vaccine in Children Admitted due to Febrile Convulsion

Authors

1 Assistant professor of Pediatric Infectious, Pediatric department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.

2 Associate Professor of Pediatric, Pediatric department, Mousavi Hospital, Zanjan University of Medical Science, Zanjan, Iran.

3 General practitioner, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.

4 Associate Professor of Pediatric Gastroenterology, Pediatric Gastroenterology and Hepatology Research Center, Department of Pediatric, Bahrami children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background
Febrile convulsion (FC) is the most common neurological problem in children which can occur in 2 to 5% of this population. The most important issue is to identify the cause of fever and rule out bacterial meningitis. The purpose of this study was to evaluate the association of aseptic meningitis due to Measles-Mumps-Rubella (MMR) vaccine in admitted children with febrile convulsion.
Materials and Methods
This study was a retrospective cross-sectional. Children aged 6 months to 5 years old with FC that admitted to Mousavi Hospital in Zanjan, Iran, during one year (from 2016 to 2017) were enrolled. The demographic information of patients and laboratory parameters of meningitis in their CSF fluid were recorded in a researcher made questionnaire.
Results
A total of 275 children were admitted due to FC. Of these children, 36.3% had respiratory infections, 33.8% nonspecific febrile infections, 16% gastroenteritis, 5.8% urinary tract infection, 5.1% acute otitis media and 2.2% meningitis. All cases of meningitis were aseptic without evidence of bacterial compromise. There was a significant relationship between the age of febrile convulsion and meningitis (P=0.012). The age of children with meningitis were between 385 to 395 days (equivalent one year and 20- 30 days), which coincide with 20 to 30 days after receiving the MMR vaccine.
Conclusion
In the study, all cases of meningitis occurred 20 to 30 days after the MMR vaccine at one year of age. It is strongly suspected the association between aseptic meningitis and the MMR vaccine. LP is recommended in children with febrile convulsions in this age range.

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