Feber og hudblødninger hos børn--er det meningokoksygdom?

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Our main aims were to establish criteria for early distinction between meningococcal disease and other conditions with similar clinical features, and to identify other causes of haemorrhagic rashes accompanied by fever.

MATERIALS AND METHODS: This prospective study comprised 264 infants and children hospitalised with fever and skin haemorrhages.

RESULTS: We identified an aetiological agent in 28%: 15% had meningococcal disease, 2% another invasive bacterial infection, 7% enterovirus infection, and 4% adenovirus infection. Five clinical variables discriminated meningococcal disease from other conditions on admission: skin haemorrhages of (1) characteristic appearance; (2) universal distribution and (3) a maximum diameter of > 2 mm; (4) poor general condition; and (5) nuchal rigidity.

DISCUSSION: If any two or more of these clinical variables were present, the probability of identifying a patient with meningococcal disease was 97% and the false-positive rate was only 12%. This diagnostic algorithm did not identify children in whom septicaemia was caused by other bacterial species.

Details

Authors
  • Hans Erik Nielsen
  • Erik Arthur Andersen
  • Jesper Andersen
  • Blenda Böttiger
  • Karsten Maidahl Christiansen
  • Peder Stjernholm Daugbjerg
  • Severin Olesen Larsen
  • Inga Lind
  • Marta Nir
  • Kern Olofsson
External organisations
  • Gentofte Hospital
  • Danish Serum Institute, Copenhagen
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Infectious Medicine

Keywords

  • Child, Child, Preschool, Diagnosis, Differential, Fever/diagnosis, Hemorrhage/diagnosis, Humans, Infant, Meningitis, Bacterial/diagnosis, Meningitis, Viral/diagnosis, Meningococcal Infections/diagnosis, Microbiological Techniques, Prospective Studies, Skin/pathology, Skin Diseases, Bacterial/diagnosis, Skin Diseases, Viral/diagnosis
Translated title of the contributionFever and skin hemorrhages in children--is it meningococcal disease?
Original languageDanish
Pages (from-to)2617-2623
Number of pages7
JournalUgeskrift for Laeger
Volume164
Issue number20
Publication statusPublished - 2002 May 13
Publication categoryResearch
Peer-reviewedYes
Externally publishedYes