Early diagnosis model for meningitis supports public health decision making - 02/08/11
, Oluwatoyin O. Ejidokun b, Neville Q. Verlander c, Graham Fraser d, Margie Meltzer e, Yasmin Rehman f, Peter Muir g, Nelly Ninis h, James M. Stuart i
Corresponding author. Tel.: +1452 378900; fax: +1452 378902.Summary |
Objective |
To develop a predictive model for rapid differential diagnosis of meningitis and meningococcal septicaemia to support public health decisions on chemoprophylaxis for contacts.
Methods |
Prospective study of suspected cases of acute meningitis and meningococcal septicaemia admitted to hospitals in the South West, West Midlands and London Regions of England from July 2008 to June 2009. Epidemiological, clinical and laboratory variables on admission were recorded. Logistic regression was used to derive a predictive model.
Results |
Of the 719 suspect cases reported, 385 confirmed cases were included in analysis. Peripheral blood polymorphonuclear count of >16 × 109/l, serum C-reactive protein of >100 mg/l and haemorrhagic rash were strongly and independently associated with diagnosis of bacterial meningitis and meningococcal septicaemia. Using a simple scoring system, the presence of any one of these factors gave a probability of >95% in predicting the final diagnosis.
Conclusion |
We have developed a model using laboratory and clinical factors, but not dependent on availability of CSF, for differentiating acute bacterial from viral meningitis within a few hours of admission to hospital. This scoring system is recommended in public health management of suspected cases of meningitis and meningococcal septicaemia to inform decisions on chemoprophylaxis.
Le texte complet de cet article est disponible en PDF.Keywords : Meningitis, Meningococcal infection, Predictive model
Plan
 | On behalf of the Diagnostic Meningitis Study Group. |
| Data and models using CSF factors and meningococcal vs. pneumococcal infection are available on request to: Rebecca.close@hpa.org.uk. |
Vol 63 - N° 1
P. 32-38 - juillet 2011 Retour au numéro
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