AIMS: To establish criteria for early distinction between meningococcal disease and other conditions with similar clinical features, and to identify other causes for haemorrhagic rashes accompanied by fever. METHODS: In a prospective study, 264 infants and children hospitalised with fever and skin haemorrhages were studied. RESULTS: We identified an aetiological agent in 28%: 15% had meningococcal disease, 2% another invasive bacterial infection, 7% enterovirus infection, and 4% adenovirus infection. Five clinical variables distinguished between meningococcal disease and other conditions on admission: (1) skin haemorrhages of characteristic appearance; (2) universal distribution of skin haemorrhages; (3) maximum diameter of one or more skin haemorrhages greater than 2 mm; (4) poor general condition (using a standardised observation scheme); and (5) nuchal rigidity. If any two or more of these clinical variables were present, the probability of identifying a patient with meningococcal disease was 97% and the false positive rate was only 12%. This diagnostic algorithm did not identify children in whom septicaemia was caused by other bacterial species.
AIMS: To establish criteria for early distinction between meningococcal disease and other conditions with similar clinical features, and to identify other causes for haemorrhagic rashes accompanied by fever. METHODS: In a prospective study, 264 infants and children hospitalised with fever and skin haemorrhages were studied. RESULTS: We identified an aetiological agent in 28%: 15% had meningococcal disease, 2% another invasive bacterial infection, 7% enterovirus infection, and 4% adenovirus infection. Five clinical variables distinguished between meningococcal disease and other conditions on admission: (1) skin haemorrhages of characteristic appearance; (2) universal distribution of skin haemorrhages; (3) maximum diameter of one or more skin haemorrhages greater than 2 mm; (4) poor general condition (using a standardised observation scheme); and (5) nuchal rigidity. If any two or more of these clinical variables were present, the probability of identifying a patient with meningococcal disease was 97% and the false positive rate was only 12%. This diagnostic algorithm did not identify children in whom septicaemia was caused by other bacterial species.
Authors: P L McCarthy; M R Sharpe; S Z Spiesel; T F Dolan; B W Forsyth; T G DeWitt; H D Fink; M A Baron; D V Cicchetti Journal: Pediatrics Date: 1982-11 Impact factor: 7.124
Authors: Erin F Mathes; Vikash Oza; Ilona J Frieden; Kelly M Cordoro; Shigeo Yagi; Renee Howard; Leonard Kristal; Christine C Ginocchio; Julie Schaffer; Sheilagh Maguiness; Susan Bayliss; Irene Lara-Corrales; Maria Teresa Garcia-Romero; Dan Kelly; Maria Salas; M Steven Oberste; W Allan Nix; Carol Glaser; Richard Antaya Journal: Pediatrics Date: 2013-06-17 Impact factor: 7.124
Authors: Ann Van den Bruel; Rudi Bruyninckx; Etienne Vermeire; Peter Aerssens; Bert Aertgeerts; Frank Buntinx Journal: BMC Fam Pract Date: 2005-08-26 Impact factor: 2.497
Authors: Thomas Waterfield; Derek Fairley; Bronagh Blackwood; James McKenna; Michael D Shields Journal: BMC Pediatr Date: 2019-02-07 Impact factor: 2.125