Journal Article

Fever Interval before Diagnosis, Prior Antibiotic Treatment, and Clinical Outcome for Young Children with Bacterial Meningitis

Bema K. Bonsu and Marvin B. Harper

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 4, pages 566-572
Published in print February 2001 | ISSN: 1058-4838
Published online February 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/318700
Fever Interval before Diagnosis, Prior Antibiotic Treatment, and Clinical Outcome for Young Children with Bacterial Meningitis

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In young children, meningitis due to Streptococcus pneumoniae is preceded by a long interval from onset of fever to diagnosis of bacterial meningitis (hereafter known as “fever interval”), during which time the patient frequently contacts a clinician. By means of retrospective chart review, we compared the fever interval that preceded diagnosis with the complication rate among 288 young children (age, 3–36 months) who had bacterial meningitis (1984–1996), as stratified by causative organism and prior antibiotic treatment. Pathogens included S. pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis. Pneumococcus species were associated with the longest fever interval prior to diagnosis of meningitis, the highest frequency of contact with a clinician before hospitalization, and the highest rate of documented morbidity or mortality. For S. pneumoniae, there was an association between antibiotic treatment received at prior meetings with a clinician and a reduced rate of meningitis-related complications (odds ratio, 0.14; P = .02). Antibiotic treatment during such meetings is associated with a substantial reduction in disease-related sequelae.

Journal Article.  4604 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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