[P3-28] Adjunct Therapy with Ketogenic Diet to Infant Bacterial Meningitis
Background: Ketogenic diet (KD) could provide energy to brain, could be an adjunct therapy because of its acction of anti-microorganisms, anti-inflammation, antiseizure and neuroprotection.Method: This is a retrospective case study of two cases with bacterial meningitis.Results: Case1, 1.5 month-female infant because of a 30 minutes seizure with pneumonia streptococcal meningitis. On day 2, her focal seizures were deteriorated (seizures lasting for 11 days, PICU stay 2 days). Informed consent and medical ethinic permission was performed.On day three of admission KD was added with 2:1 Qitong(Zeneca,China) liquid ketogenic diet. 3 days later the ratio of KD adjusted to 3:1. On day 7, three days after ketosis the glucose in cerebral spinial fluid increased quickly from 0.02 mmol/L to 1.98mmol/L, and white cell counts and protein decreased significanly within one week as well.The blood glucose level was 2.8-5.3mmol/L. The blood ketone body(beta-hydroxybutyric acid) level was 0.5-3mmol/L. The KD was discontinued after 3 months. Though after 5.5 months the MRI scan showed mild atrophy of the left brain, no more seizures happened. Her physical and neuropsychological development is similar to that of her same age children at 2.5 years old. Case 2, 11-month male infant with pneumonia streptococcal menigitis initiated KD after day 32 of onset because of severe seizures,KD successfully decreased seizures but the patient died because of other causes（case 1 has published elsewhere）.Conclusions: KD might be an safe and effective adjunctive therapy for bacterial meningitis.