Objective: To develop a predictive model for rapid differential diagnosis of meningitis and meningococcal septicaemia to support public health decisions on chemoprophylaxis for contacts.
Methods: Prospective study of suspected cases of acute meningitis and meningococcal septicaemia admitted to hospitals in the South West, West Midlands and London Regions of England from July 2008 to June 2009. Epidemiological, clinical and laboratory variables on admission were recorded. Logistic regression was used to derive a predictive model.
Results: Of the 719 suspect cases reported, 385 confirmed cases were included in analysis. Peripheral blood polymorphonuclear count of >16 × 10(9)/l, serum C-reactive protein of >100 mg/l and haemorrhagic rash were strongly and independently associated with diagnosis of bacterial meningitis and meningococcal septicaemia. Using a simple scoring system, the presence of any one of these factors gave a probability of >95% in predicting the final diagnosis.
Conclusion: We have developed a model using laboratory and clinical factors, but not dependent on availability of CSF, for differentiating acute bacterial from viral meningitis within a few hours of admission to hospital. This scoring system is recommended in public health management of suspected cases of meningitis and meningococcal septicaemia to inform decisions on chemoprophylaxis.
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http://dx.doi.org/10.1016/j.jinf.2011.03.013 | DOI Listing |
Lancet Digit Health
December 2024
Nuffield Department of Population Health, University of Oxford, Oxford, UK. Electronic address:
Microbiology reference laboratories perform a crucial role within public health systems. This role was especially evident during the COVID-19 pandemic. In this Viewpoint, we emphasise the importance of microbiology reference laboratories and highlight the types of digital data and expertise they provide, which benefit national and international public health.
View Article and Find Full Text PDFHum Vaccin Immunother
December 2024
Real-World Evidence, Evidera, Waltham, MA, USA.
Invasive meningococcal disease (IMD) is a life-threatening yet vaccine-preventable disease, with vaccines approved and recommended in the United States by the Centers for Disease Control and Prevention. This study assessed complications, mortality, healthcare resource utilization (HCRU), and healthcare costs among a sample of commercially-insured individuals living in the United States who experienced IMD. We used retrospective data from large claims databases limited to individuals with IMD covered by commercial health plans between January 2010-March 2022.
View Article and Find Full Text PDFJAMA Netw Open
December 2024
Division of Clinical Epidemiology, Department of Medicine (Solna), Karolinska Institute, Stockholm, Sweden.
BMJ
November 2024
Meningitis Research Foundation, The Pithay, Bristol, UK (retired).
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