Featured Research

from universities, journals, and other organizations

Clinical Guidelines Help Identify Which Children At Risk Of Bacterial Meningitis

Date:
January 4, 2007
Source:
JAMA and Archives Journals
Summary:
A set of guidelines have been developed that can help predict the risk of bacterial meningitis for children with cerebrospinal fluid pleocytosis (presence of greater number of white blood cells than normal), reducing unnecessary hospitalizations and antibiotics, according to a study in the Jan. 3 issue of JAMA.

A set of guidelines have been developed that can help predict the risk of bacterial meningitis for children with cerebrospinal fluid pleocytosis (presence of greater number of white blood cells than normal), reducing unnecessary hospitalizations and antibiotics, according to a study in the January 3 issue of JAMA.

Related Articles


Although bacterial meningitis is the greatest concern when evaluating and treating children with cerebrospinal fluid (CSF) pleocytosis, the majority of these children have viral rather than bacterial meningitis, according to background information in the article. However, because exclusion of bacterial meningitis requires negative CSF (and blood) cultures after 2 to 3 days of incubation, most children with CSF pleocytosis are admitted to the hospital to receive broad-spectrum antibiotics while awaiting culture test results. A highly accurate decision support tool that could identify which children with CSF pleocytosis had a near-zero risk of bacterial meningitis by using clinical and laboratory measures readily available at the time the child is in the clinic could guide decision making and limit unnecessary hospital admissions and prolonged antibiotic use.

Lise E. Nigrovic, M.D., M.P.H., of Children's Hospital Boston and Harvard Medical School, and colleagues conducted a study to validate in a large population the clinical prediction rule, the Bacterial Meningitis Score, which classifies patients at very low risk of bacterial meningitis if they lack 5 criteria, which include certain CSF measurements and a history of seizure. The multicenter study was conducted in the emergency departments of 20 U.S. academic medical centers between January 2001 and June 2004 and included 3,295 children, age 29 days to 19 years with CSF pleocytosis.

Among these patients, 121 (3.7 percent) had bacterial meningitis and 3,174 (96.3 percent) had aseptic (nonbacterial) meningitis. Of the 1,714 patients categorized as very low risk by the Bacterial Meningitis Score, only 2 had bacterial meningitis (both were younger than 2 months old) and 1,712 had aseptic meningitis. The sensitivity of the Bacterial Meningitis Score (i.e., having 1 or more Bacterial Meningitis Score risk factor) for bacterial meningitis was 98.3 percent and the specificity was 61.5 percent.

The authors write that for patients with at least 1 Bacterial Meningitis Score risk factor or who are younger than 2 months, they suggest admission to the hospital and administration of parenteral (administered intravenously or by injection) antibiotics.

"In the conjugate H influenzae type b and pneumococcal vaccines era, bacterial meningitis has become an uncommon disease in U.S. children. Therefore, the majority of children with CSF pleocytosis have aseptic rather than bacterial meningitis. Furthermore, our study confirms that most children with CSF pleocytosis are admitted to the hospital to receive parenteral antibiotics while awaiting bacterial culture test results. Using the Bacterial Meningitis Score prediction rule to assist with clinical decision making could substantially reduce unnecessary hospital admissions for children with CSF pleocytosis at very low risk of bacterial meningitis. Future investigations should study the clinical implementation of the Bacterial Meningitis Score as a guide to help care for children with CSF pleocytosis," the researchers conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Cite This Page:

JAMA and Archives Journals. "Clinical Guidelines Help Identify Which Children At Risk Of Bacterial Meningitis." ScienceDaily. ScienceDaily, 4 January 2007. <www.sciencedaily.com/releases/2007/01/070102164941.htm>.
JAMA and Archives Journals. (2007, January 4). Clinical Guidelines Help Identify Which Children At Risk Of Bacterial Meningitis. ScienceDaily. Retrieved April 2, 2015 from www.sciencedaily.com/releases/2007/01/070102164941.htm
JAMA and Archives Journals. "Clinical Guidelines Help Identify Which Children At Risk Of Bacterial Meningitis." ScienceDaily. www.sciencedaily.com/releases/2007/01/070102164941.htm (accessed April 2, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, April 2, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Wound-Healing Laser Soon to Be a Reality Israeli Scientist

Wound-Healing Laser Soon to Be a Reality Israeli Scientist

Reuters - Innovations Video Online (Apr. 1, 2015) Israeli scientists says laser bonding of tissue allows much faster healing and less scarring. Amy Pollock has more. Video provided by Reuters
Powered by NewsLook.com
Liberia Sees Resurgence of Drug Trafficking as Ebola Wanes

Liberia Sees Resurgence of Drug Trafficking as Ebola Wanes

AFP (Apr. 1, 2015) The governments of Liberia and Sierra Leone have been busy fighting the menace created by the deadly Ebola virus, but illicit drug lords have taken advantage of the situation to advance the drug trade. Duration: 01:12 Video provided by AFP
Powered by NewsLook.com
Stigma Stalks India's Leprosy Sufferers as Disease Returns

Stigma Stalks India's Leprosy Sufferers as Disease Returns

AFP (Apr. 1, 2015) The Indian government declared victory over leprosy in 2005, but the disease is making a comeback in some parts of the country, with more than a hundred thousand lepers still living in colonies, shunned from society. Duration: 02:41 Video provided by AFP
Powered by NewsLook.com
7-Year-Old Girl Gets 3-D Printed 'robohand'

7-Year-Old Girl Gets 3-D Printed 'robohand'

AP (Mar. 31, 2015) Although she never had much interest in prosthetic limbs before, Faith Lennox couldn&apos;t wait to slip on her new robohand. The 7-year-old, who lost part of her left arm when she was a baby, grabbed it as soon as it came off a 3-D printer. (March 31) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins