title: [Fever and skin hemorrhages in children--is it meningococcal disease?].
abstract: BACKGROUND
  Our main aims were to establish criteria for early distinction between meningococcal disease and other conditions with similar clinical features, and to identify other causes of haemorrhagic rashes accompanied by fever.
  
  
  METHODS
  This prospective study comprised 264 infants and children hospitalised with fever and skin haemorrhages.
  
  
  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 discriminated meningococcal disease from other conditions on admission: skin haemorrhages of (1) characteristic appearance; (2) universal distribution and (3) a maximum diameter of > 2 mm; (4) poor general condition; and (5) nuchal rigidity.
  
  
  CONCLUSIONS
  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.affiliation: Amtssygehuset i Gentofte, DK-2900 Hellerup.
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Nielsen
authors.forename: Erik Arthur
authors.initials: EA
authors.lastname: Andersen
authors.forename: Jesper
authors.initials: J
authors.lastname: Andersen
authors.forename: Blenda
authors.initials: B
authors.lastname: Böttiger
authors.forename: Karsten Maidahl
authors.initials: KM
authors.lastname: Christiansen
authors.forename: Peder Stjernholm
authors.initials: PS
authors.lastname: Daugbjerg
authors.forename: Severin Olesen
authors.initials: SO
authors.lastname: Larsen
authors.forename: Inga
authors.initials: I
authors.lastname: Lind
authors.forename: Marta
authors.initials: M
authors.lastname: Nir
authors.forename: Kern
authors.initials: K
authors.lastname: Olofsson
mesh_terms: D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005334:Fever / Q000175:diagnosis* / Q000382:microbiology / Q000821:virology; D006470:Hemorrhage / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D007223:Infant; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D008587:Meningitis, Viral / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D008589:Meningococcal Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D008828:Microbiological Techniques; D011446:Prospective Studies; D012867:Skin / Q000473:pathology*; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D017193:Skin Diseases, Viral / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology
vernacular_title: Feber og hudblødninger hos børn--er det meningokoksygdom?