Print Diagnosis Your family doctor or pediatrician can diagnose meningitis based on a medical history, a physical exam and certain diagnostic tests. During the exam, your doctor may check for signs of infection around the head, ears, throat and the skin along the spine.
This journal club will review lab tests that are better indicators of serious bacterial illness, how to reduce the rate of blood culture contaminants, the significance of the clinical examination for the diagnosis of meningitis and whether or not a routine lumbar puncture is necessary in children less than 18 months of age with a first time, simple febrile seizure.
The issue of serious bacterial illness in children is an ongoing debate and new articles are emerging that help shed some light on the topic. After evaluating this article, participants will be able to: Incorporate strategies into practice for the appropriate assessment of laboratory data in febrile infants.
Develop strategies to reduce the false positive rate of blood cultures. Develop strategies to avoid the misdiagnosis of meningitis.
Can newborns who present with fever for less than 12 hours of duration and have normal initial laboratory findings still be at risk for serious bacterial illness A.
In this study, there were 5 neonates who had initially normal lab findings who had subsequent serious bacterial illness. In addition, the authors conclude that C-reactive protein and Absolute Neutrophil Counts ANC are better indicators than a peripheral white blood cell count.
Laboratory Markers Accuracy and Duration of Fever. Pediatr Infect Dis J ; An observational study was conducted on previously healthy neonates 7 to 28 days of age, consecutively hospitalized for FWS from less than 12 hours to a tertiary care Pediatric Emergency Department, over a 4-year period.
Laboratory markers were obtained upon admission in all patients and repeated 6 to 12 hours from admission in those with normal values on initial determination. Sensitivity, specificity, positive and negative likelihood ratios, and receiver operating characteristic analysis were carried out for primary and repeated laboratory examinations.
Ninety-nine patients were finally studied. SBI was documented in 25 Areas under receiver operating characteristic curves were 0.
Sixty-two patients presented normal laboratory markers on initial determination. Five of them had an SBI. The area under curve calculated for repeated laboratory tests showed better values, respectively of 0.
This is an interesting concept as we commonly see newborns presenting with fever without source prior to 12 hours of fever. While more studies are necessary to fine tune our evaluation and management in the fragile neonatal age group, it may be prudent to repeat laboratory evaluation after admission in those patients who were initially evaluated prior to 12 hours of symptom onset.
Should blood cultures be drawn from a separate site rather than being obtained while starting an intravenous line? In this study, a phlebotomty policy change which required a separate blood draw for blood cultures significantly reduced the contamination rate.
Culture Contamination in a Pediatric Emergency Department. March — Volume 27 — Issue 3 — pp Background: Blood cultures BCs are used to diagnose bacteremia in febrile children.
False-positive BCs increase costs because of further testing, longer hospital stays, and unnecessary antibiotic therapy. A phlebotomy policy change was made whereby BC had to be obtained by a second venipuncture and no longer obtained during insertion of intravenous catheters.Acute bacterial meningitis is a life‐threatening illness.
Currently the evidence suggests that old and new antibiotics offer the same level of treatment. Currently the evidence suggests that old and new antibiotics offer the same level of treatment.
Conclusion: Duration of illness and cranial nerve palsies are important variables in the diagnosis of TBM stages and if TBM is suspected, empiric treatment should be started immediately without bacteriologic proof to prevent morbidity and mortality.
Key words: Tuberculous meningitis. British Medical Research Council (BMRC) stages. New research commissioned by GSK has shown that the majority of parents incorrectly think that a rash or stiff neck are the first signs of meningitis.
Two UH researchers have won a five-year, $ For a definitive diagnosis of meningitis, you'll need a spinal tap to collect cerebrospinal fluid (CSF). In people with meningitis, the CSF often shows a low sugar (glucose) level along with an increased white blood cell count and increased protein.
CSF analysis may also help your doctor identify which bacterium caused the meningitis. Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges.
There are several types of meningitis. Meningitis is an acute inflammation of meninges caused by bacterial, viral or fungal infection. Meningitis can also be caused by bleeding into the meninges, cancer, an inflammatory response to certain types of chemotherapy or other chemical agents.