A revised clinical method for assessment of severity of acute bacterial meningitis.
The aim of this study was to simplify a previously described clinical method of assessing severity of meningitis. An 8.5-point, six-item model for the risk of an abnormal course (seizures during treatment) or adverse outcome (death or recovery with neurological sequelae) was developed using a set of six bedside features: age < or = 2 yrs, 2 points; duration of illness > 7 days, 1.5 points; seizures, 2.5 points; hypovolaemic shock, 1 point; coma, 0.5 point; and abnormal muscle tone, 1 point. A high-risk score (< or = 2.5 points) was associated with a relative risk (95% CI) of 7.4 (2.4, 22.7) of seizures during treatment, and 6.3 (2.6, 17.2) for an adverse outcome (death or major or minor sequelae). The revised model should be suitable for use where laboratory facilities are not readily available, as in many developing countries, or when contra-indications to lumbar puncture are an important consideration on admission, as in severely ill patients, as well as when there are not such limitations.
Akpede
George O
GO
Department of Paediatrics, University of Maiduguri Teaching Hospital, Maiduguri, and Otibhor Okhae Teaching Hospital, Irrua, Nigeria. public@fidelsemper.com
Jalo
Ilya
I
Dawodu
Simeon O
SO
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D016015:Logistic Models; D016920:Meningitis, Bacterial / Q000150:complications / Q000175:diagnosis*; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012640:Seizures / Q000382:microbiology; D012720:Severity of Illness Index; D015996:Survival Rate