Health Team

New Procedure Gives Clearer Diagnosis of Meningitis in Children

Posted January 2, 2007

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— Thousands of children with meningitis go to hospital emergency departments each year. Until now, doctors have not had a quick way to diagnose which type patients have.

If a child comes to a hospital with a stiff neck, fever and a headache, doctors would test them for meningitis, an inflammation of the membranes covering the brain and spinal cord. Viral meningitis is much less serious than bacterial meningitis.

"Bacterial meningitis is a potentially life-threatening and serious condition, which requires intravenous antibiotics at hospital admission," said Dr. Lise Nigrovic with Children's Hospital in Boston, Mass.

To be safe, many physicians start children on antibiotics while they wait for the bacterial culture that tells them which type of meningitis they are treating. It could take two to three days before results from that test are final.

In the meantime, if it's viral meningitis, antibiotics will not help and over-using them makes them less effective over time.

A nationwide study published in the Journal of the American Medical Association found a way to predict which cases are likely not bacterial.

"The absence of seizure as well as defined blood and spinal fluid tests identified a low-risk group for bacterial meningitis. And in that group, the risk of bacterial meningitis was one in a thousand," Nigrovic said.

The results of those tests come back in minutes instead of days. The algorithm, or set of information, is 99.9 percent accurate. It could reduce the unnecessary use of antibiotics and allow more patients to go home earlier.

Researchers looked at about 3,000 cases of meningitis in children who went to emergency departments over 3-1/2 years.

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