Febrile Coma in the Pediatric Unit of the National University Teaching Hospital (CNHU) of Cotonou: Etiologic and Therapeutic Features and Outcome
Objective: Describe the epidemiological, clinical and therapeutic features and the outcome of comas among febrile children in the CNHU- Cotonou.
Material and methods: This research work was a case-control and descriptive study focused on 97 children aged one (01) month to 15 years admitted to the said unit, from January 1 to December 31, 2014 for fever induced coma. Coma was assessed using Blantyre and Glasgow scores. The study involved all children with coma during more than 24 hours after admission and with temperature higher or equal to à 38°C.
Findings: Mean age was 56 months and sex ratio 1.1. In addition to coma, respiratory distress, anemia and convulsions were identified respectively in 24, 16 and 31 cases. 61.9% of isolated pathogens were Plasmodium Falciparum but only case of N meningitidis and one case of Klebsiella P were registered. Bacterial meningitis with unidentified pathogen was found in 10 cases and no etiology was identified in 25 cases. Antimalarial drug was used in 61.9% of cases and probabilistic antibiotic therapy in 36% of cases. After-effects such as aphasia and blindness were observed on discharge of the patient in 14.4% of the cases. Death rate was 6.2%. Coma duration higher than 7 days was associated with occurrence of after-effects (P=0.04).
Conclusion: Viral culture should be put in place in Benin in order to extend etiological research. The fight against malaria must be pursued.