Existing guidelines accurately distinguish between cases of viral and more dangerous bacterial meningitis, reducing the number of unnecessary hospitalizations and antibiotics that are given to child.
January 4, 2007 (Press Release) --
Existing guidelines accurately distinguish between cases of viral and more dangerous bacterial meningitis, reducing the number of unnecessary hospitalizations and antibiotics that are given to children, researchers report.
The tool should also be used by emergency room physicians, concludes the study in the Jan. 3 issue of the Journal of the American Medical Association.
"The previously published and derived 'decision rule' worked well or better than anything else we could come up with," said principal investigator Dr. Lise E. Nigrovic, an attending physician in pediatric emergency medicine at Children's Hospital Boston. "It's the most accurate clinical prediction rule to discriminate between bacterial and viral meningitis."
"This would support some clinicians -- particularly [those] seeing an older child with what looks like viral meningitis -- in saying, 'I don't really need to hospitalize this child now, I can follow him as an outpatient,'" added Dr. Nathan Litman, director of pediatrics and pediatric infectious diseases at Children's Hospital at Montefiore Medical Center in New York City.
Improved diagnosis is incredibly important in treating meningitis, "potentially saving costly hospitalization and potentially avoiding initiating an IV line of antibiotics that would be unnecessary," he said.
Meningitis is a potentially life-threatening inflammation of the membranes (meninges) surrounding the brain and spinal cord. Patients with the condition are usually identified by a higher-than-normal number of white blood cells in the spinal fluid. Most cases of meningitis are caused by viral infections, but about one in 25 are caused by bacterial or fungal infections. Bacterial meningitis, while relatively rare, is much more severe and can lead to disability and even death.
"The conundrum is that you have a very rare but serious disease, bacterial meningitis, and a much more common but less serious viral meningitis," Nigrovic said.
It takes two days for a culture to come back to prove that the meningitis is bacterial or viral. Unfortunately, doctors typically have to decide right away how to treat the patient.
"Often, patients are admitted to the hospital," Nigrovic said. "If a physician was actually able to determine a patient was at low risk for bacterial meningitis before the cultures came back, they might consider treating them as outpatients and avoiding some of the potentially harmful consequences of hospitalization."
The authors of the current study had previously developed the Bacterial Meningitis Score, to help doctors identify patients at very low risk of bacterial meningitis. Individuals were considered at low risk if they lacked five criteria, including certain cerebrospinal fluid measurements and a history of seizures.
source: http://health.msn.com/
The tool should also be used by emergency room physicians, concludes the study in the Jan. 3 issue of the Journal of the American Medical Association.
"The previously published and derived 'decision rule' worked well or better than anything else we could come up with," said principal investigator Dr. Lise E. Nigrovic, an attending physician in pediatric emergency medicine at Children's Hospital Boston. "It's the most accurate clinical prediction rule to discriminate between bacterial and viral meningitis."
"This would support some clinicians -- particularly [those] seeing an older child with what looks like viral meningitis -- in saying, 'I don't really need to hospitalize this child now, I can follow him as an outpatient,'" added Dr. Nathan Litman, director of pediatrics and pediatric infectious diseases at Children's Hospital at Montefiore Medical Center in New York City.
Improved diagnosis is incredibly important in treating meningitis, "potentially saving costly hospitalization and potentially avoiding initiating an IV line of antibiotics that would be unnecessary," he said.
Meningitis is a potentially life-threatening inflammation of the membranes (meninges) surrounding the brain and spinal cord. Patients with the condition are usually identified by a higher-than-normal number of white blood cells in the spinal fluid. Most cases of meningitis are caused by viral infections, but about one in 25 are caused by bacterial or fungal infections. Bacterial meningitis, while relatively rare, is much more severe and can lead to disability and even death.
"The conundrum is that you have a very rare but serious disease, bacterial meningitis, and a much more common but less serious viral meningitis," Nigrovic said.
It takes two days for a culture to come back to prove that the meningitis is bacterial or viral. Unfortunately, doctors typically have to decide right away how to treat the patient.
"Often, patients are admitted to the hospital," Nigrovic said. "If a physician was actually able to determine a patient was at low risk for bacterial meningitis before the cultures came back, they might consider treating them as outpatients and avoiding some of the potentially harmful consequences of hospitalization."
The authors of the current study had previously developed the Bacterial Meningitis Score, to help doctors identify patients at very low risk of bacterial meningitis. Individuals were considered at low risk if they lacked five criteria, including certain cerebrospinal fluid measurements and a history of seizures.
source: http://health.msn.com/
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