Prevalence and Predictors of Bacterial Meningitis in Young Infants With Fever Without a Source

Martinez, Elena; Mintegi, Santiago; Vilar, Begoña; Martínez, María Jesús; Lopez, A; Catediano, E.; Gómez, Borja

doi:10.1097/inf.0000000000000629

Cited by 33 publications

(15 citation statements)

References 25 publications

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“…Martinez et al reported on the prevalence of BM among febrile infants less than 90 days old. 22 Of the almost 2,000 well-appearing febrile infants greater than 21 days old, none had BM. However, only about one-fifth of these study subjects had an LP performed and the total number of infants 29–56 days old was not reported.…”

Section: Discussionmentioning

confidence: 97%

Lumbar Puncture for All Febrile Infants 29-56 Days Old: A Retrospective Cohort Reassessment Study

Scarfone

Murray

Gala

et al. 2017

The Journal of Pediatrics

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Objectives To determine the incidence of bacterial meningitis (BM) among all febrile infants 29–56 days old undergoing a lumbar puncture (LP) in the emergency department (ED) of a tertiary care children’s hospital and the number of low-risk FYI with BM, in order to reassess the need for routine LP in these infants. Study design Retrospective cohort study using a quality improvement registry from July 2007-April 2014. Infants included were 29–56 days old with fever and who had an LP in the ED. Low-risk criteria were adapted from the Philadelphia criteria. 4BM was defined as having a bacterial pathogen isolated from the cerebrospinal fluid (CSF). A medical record review of one-third of randomly selected patients in the cohort determined the proportion who met low-risk criteria. Results One of 1188 (0.08%) FYI had BM; this patient did not meet low-risk criteria. An additional 40 (3.4%) had positive CSF cultures; all were contaminants. Sub-analysis of one-third of the study population revealed that 45.6% met low-risk criteria; the most common reasons for failing low-risk classification included abnormal white blood cell count or urinalysis. Conclusions In a cohort of FYI, BM is uncommon and no cases of BM would have been missed had LPs not been performed in those meeting low-risk criteria.

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Section: Discussionmentioning

confidence: 97%

Lumbar Puncture for All Febrile Infants 29-56 Days Old: A Retrospective Cohort Reassessment Study

Scarfone

Murray

Gala

et al. 2017

The Journal of Pediatrics

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“…A confirmed bacterial etiology was based on a positive cerebrospinal fluid culture, positive results on direct examination of the cerebrospinal fluid with a negative culture, the presence of soluble antigens in the cerebrospinal fluid, positive polymerase chain reaction (PCR) results in the cerebrospinal fluid, or a positive blood culture associated with cerebrospinal fluid pleocytosis (>10 cells/mm 3 ). [6][7][8] Probable bacterial meningitis was diagnosed based on the criteria of the World Health Organization (WHO) 9 : clinical signs and symptoms of meningitis, changes in the cerebrospinal fluid, and lack of an identifiable bacterial pathogen. Children who did not fulfill the criteria for bacterial meningitis were excluded from the study, as were children with tuberculous meningitis and neurobrucellosis.…”

Section: Methodsmentioning

confidence: 99%

Clinical Features of and Risk Factors for Hydrocephalus in Childhood Bacterial Meningitis

et al. 2018

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Objective: To explore the clinical characteristics of and analyze the risk factors for hydrocephalus in children with bacterial meningitis. Methods: Retrospective study of a sample of children with bacterial meningitis seen on the pediatric service of Shengjing Hospital of China Medical University between January 1, 2010, and December 31, 2016. Results: Overall, 9.36% (25/267) of patients presented with hydrocephalus. Among patients with hydrocephalus, the age at onset of bacterial meningitis was usually <6 months, 15 patients had confirmed bacterial etiology, and 1 patient died. The most significant results of multivariate analysis for hydrocephalus were a rural living situation, altered level of consciousness, previous treatment with antibiotics, initial cerebrospinal fluid protein >2 g/L, C-reactive protein >100 mg/L, and dexamethasone use. Conclusions: A severe clinical manifestation and significant laboratory index at admission are the most important predictors of hydrocephalus in children with bacterial meningitis.

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“…Nowadays, it is accepted that selected patients may be managed without a lumbar puncture 13–15. In a previous manuscript published by our group, among 1975 well-appearing febrile infants between 21 days and 90 days old, none was diagnosed with bacterial meningitis 26. On the other hand, enteroviral meningitis is a frequent diagnosis among young infants presenting with FWS admitted to paediatric EDs,27 even if they are classified as well appearing.…”

Section: Discussionmentioning

confidence: 88%

Outpatient management of selected young febrile infants without antibiotics

et al. 2016

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Prevalence and Predictors of Bacterial Meningitis in Young Infants With Fever Without a Source

Cited by 33 publications

References 25 publications

Lumbar Puncture for All Febrile Infants 29-56 Days Old: A Retrospective Cohort Reassessment Study

Lumbar Puncture for All Febrile Infants 29-56 Days Old: A Retrospective Cohort Reassessment Study

Clinical Features of and Risk Factors for Hydrocephalus in Childhood Bacterial Meningitis

Outpatient management of selected young febrile infants without antibiotics

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