Diagnostic test accuracy of jolt accentuation for headache in acute meningitis in the emergency setting

Iguchi, Masahide; Noguchi, Yoshinori; Yamamoto, Shungo; Tanaka, Yuu; Tsujimoto, Hiraku

doi:10.1002/14651858.cd012824.pub2

Cited by 8 publications

(6 citation statements)

References 62 publications

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“…Jolt accentuation of headache (JAH) is the most recently used type of physical examination to assess the irritation that occurred due to meningitis. JAH was considered positive if the headache from the inflamed meninges increased upon rotating the patient's head horizontally two or three times per second (97,140). Although reasonable levels of sensitivity and specificity of the JAH to suggest meningitis were reported, it cannot be deemed a reliable test for definitive diagnosis of VM.…”

Section: Diagnostic Challengesmentioning

confidence: 99%

“…Although reasonable levels of sensitivity and specificity of the JAH to suggest meningitis were reported, it cannot be deemed a reliable test for definitive diagnosis of VM. JAH was recommended in some studies to be used in emergency settings to exclude meningitis (57,97). Compared with the other physical examinations, the JAH showed better sensitivity and specificity rates for the diagnosis of meningitis (171).…”

Section: Diagnostic Challengesmentioning

confidence: 99%

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Etiology, Clinical Phenotypes, Epidemiological Correlates, Laboratory Biomarkers and Diagnostic Challenges of Pediatric Viral Meningitis: Descriptive Review

et al. 2022

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Meningitis is an inflammation of the brain and spinal cord meninges caused by infectious and non-infectious agents. Infectious agents causing meningitis include viruses, bacteria, and fungi. Viral meningitis (VM), also termed aseptic meningitis, is caused by some viruses, such as enteroviruses (EVs), herpesviruses, influenza viruses, and arboviruses. However, EVs represent the primary cause of VM. The clinical symptoms of this neurological disorder may rapidly be observed after the onset of the disease, or take prolonged time to develop. The primary clinical manifestations of VM include common flu-like symptoms of headache, photophobia, fever, nuchal rigidity, myalgia, and fatigue. The severity of these symptoms depends on the patient's age; they are more severe among infants and children. The course of infection of VM varies between asymptomatic, mild, critically ill, and fatal disease. Morbidities and mortalities of VM are dependent on the early recognition and treatment of the disease. There were no significant distinctions in the clinical phenotypes and symptoms between VM and meningitis due to other causative agents. To date, the pathophysiological mechanisms of VM are unclear. In this scientific communication, a descriptive review was performed to give an overview of pediatric viral meningitis (PVM). PVM may occasionally result in severe neurological consequences such as mental retardation and death. Clinical examinations, including Kernig's, Brudzinski's, and nuchal rigidity signs, were attempted to determine the clinical course of PVM with various success rates revealed. Some epidemiological correlates of PVM were adequately reviewed and presented in this report. They were seen depending mainly on the causative virus. The abnormal cytological and biochemical features of PVM were also discussed and showed potentials to distinguish PVM from pediatric bacterial meningitis (PBM). The pathological, developmental, behavioral, and neuropsychological complications of PVM were also presented. All the previously utilized techniques for the etiological diagnosis of PVM which include virology, serology, biochemistry, and radiology, were presented and discussed to determine their efficiencies and limitations. Finally, molecular testing, mainly PCR, was introduced and showed 100% sensitivity rates.

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Section: Diagnostic Challengesmentioning

confidence: 99%

Section: Diagnostic Challengesmentioning

confidence: 99%

Etiology, Clinical Phenotypes, Epidemiological Correlates, Laboratory Biomarkers and Diagnostic Challenges of Pediatric Viral Meningitis: Descriptive Review

et al. 2022

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“…A systematic review done by Iguchi and colleagues showed that jolt accentuation can be used in emergency settings to exclude meningitis. However, the pooled sensitivity and specificity of this test (65.3%, 70.4% respectively) are considered low, and more research is needed to assess its usefulness [ 32 ]. To test for etiological agents, a lumbar puncture and collection of CSF is needed.…”

Section: Clinical Manifestations and Diagnosismentioning

confidence: 99%

Viral meningitis: an overview

et al. 2021

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“…Quality assessment of diagnostic accuracy studies-2 (QUADAS-2) was carried out to determine the study design and attributes of each included article [18] . Two independent reviewers were tasked with performing a thorough evaluation of the study, during which possible disagreements in proceedings were discussed, and a unanimous decision was reached.…”

Section: Methodsmentioning

confidence: 99%

“…Quality assessment of diagnostic accuracy studies-2 (QUADAS-2) was carried out to determine the study design and attributes of each included article. [18] Two independent reviewers were tasked with performing a thorough evaluation of the study, during which possible disagreements in proceedings were discussed, and a unanimous decision was reached. Detailed information, such as the year of publication and country, false-positive, SPE, sample types, false-negative, author's first name, SEN, true-negative, and participant characteristics, was extracted from the available literature search.…”

Section: Quality Assessment and Data Extractionmentioning

confidence: 99%

Diagnostic value of microRNA-155 in active tuberculosis

Wang

et al. 2021

Medicine

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Background: Tuberculosis (TB) is a preventable and treatable disease, but the increased mortality and morbidity associated with TB continues to be a leading cause of death globally. MicroRNA (miRNA)-155 has been recognized as a marker of many lung diseases. However, the effectiveness of this marker for diagnosing TB remains unclear.Methods: A detailed search (updated on February 6, 2021) of literature published in the Wanfang database, EMBASE, PubMed, CNKI, and Cochrane Library was conducted to identify eligible studies suitable for inclusion in the current research. The positive likelihood ratio, negative likelihood ratio, specificity, area under the curve, sensitivity, and diagnostic odds ratio were used to investigate the diagnostic potential of miRNA-155.Results: A total of 122 studies related to active TB, which completely complied with the inclusion and exclusion criteria of our metaanalysis, were included. The overall results suggested a moderately high diagnostic accuracy and efficacy of miRNA-155, with a specificity of 0.85 (95% confidence interval = 0.77-0.91) and sensitivity of 0.87 (95% confidence interval = 0.76-0.93). The result based on dysregulated status demonstrated that the upregulated group yielded better accuracy and efficacy than the downregulated group. Notably, the accuracy and efficacy of miRNA-155 in pediatric TB were higher than those in adult TB. The results showed that the accuracy and efficacy of miRNA-155 in children were higher than those in adults. Conclusion:The results of the meta-analysis suggested that miRNA-155 could serve as an effective biomarker for identifying active TB.Abbreviations: AUC = area under the curve, CI = confidence interval, DAE = diagnostic accuracy and efficacy, DOR = diagnostic odds ratio, miRNA = microRNA, MTB = Mycobacterium tuberculosis, NLR = negative likelihood ratio, PLR = positive likelihood ratio, QUADAS-2 = quality assessment of diagnostic accuracy studies-2, SEA = subgroup effect analysis, SEN = sensitivity, SPE = specificity, TB = tuberculosis, TE = threshold effect.

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Diagnostic test accuracy of jolt accentuation for headache in acute meningitis in the emergency setting

Cited by 8 publications

References 62 publications

Etiology, Clinical Phenotypes, Epidemiological Correlates, Laboratory Biomarkers and Diagnostic Challenges of Pediatric Viral Meningitis: Descriptive Review

Etiology, Clinical Phenotypes, Epidemiological Correlates, Laboratory Biomarkers and Diagnostic Challenges of Pediatric Viral Meningitis: Descriptive Review

Viral meningitis: an overview

Diagnostic value of microRNA-155 in active tuberculosis

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