Abstract
Children with bacterial meningitis often have a full blood count (FBC) measured urgently on admission. We investigated whether urgent FBC gave results that aided immediate management or predicted outcome in children with meningitis. FBCs were measured on admission during 190 episodes of bacterial meningitis in children admitted between 1984 and 1991. Significant anaemia was found in seven children, but immediate transfusion was only necessary in the three subjects who were in the Paediatric Intensive Care Unit (PICU). A white blood count of less than 5 x 10(9) L-1 was significantly associated with death (P < 0.02), but a Glasgow Coma Score of less than 8 predicted death more accurately (positive predictive value of 40%). FBC yielded immediately useful information only in the 15% of children who were admitted to PICU. Conscious level was a better predictor of outcome than FBC. We recommend that urgent FBC should be performed in children with meningitis admitted to a PICU; in other children with meningitis FBC can be analysed during normal laboratory hours.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baraff L. J., Bass J. W., Fleisher G. R., Klein J. O., McCracken G. H., Jr, Powell K. R., Schriger D. L. Practice guideline for the management of infants and children 0 to 36 months of age with fever without source. Agency for Health Care Policy and Research. Ann Emerg Med. 1993 Jul;22(7):1198–1210. doi: 10.1016/s0196-0644(05)80991-6. [DOI] [PubMed] [Google Scholar]
- Griner P. F., Glaser R. J. Sounding boards. Misuse of laboratory tests and diagnostic procedures. N Engl J Med. 1982 Nov 18;307(21):1336–1339. doi: 10.1056/NEJM198211183072109. [DOI] [PubMed] [Google Scholar]
- Herson V. C., Todd J. K. Prediction of morbidity in Hemophilus influenzae meningitis. Pediatrics. 1977 Jan;59(1):35–39. [PubMed] [Google Scholar]
- Kaplan K. M., Oski F. A. Anemia with Haemophilus influenzae meningitis. Pediatrics. 1980 Jun;65(6):1101–1104. [PubMed] [Google Scholar]
- Lembo R. M., Marchant C. D. Acute phase reactants and risk of bacterial meningitis among febrile infants and children. Ann Emerg Med. 1991 Jan;20(1):36–40. doi: 10.1016/s0196-0644(05)81115-1. [DOI] [PubMed] [Google Scholar]
- Riordan F. A., Thomson A. P., Sills J. A., Hart C. A. Bacterial meningitis in the first three months of life. Postgrad Med J. 1995 Jan;71(831):36–38. doi: 10.1136/pgmj.71.831.36. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rutter N., Smales O. R. Role of routine investigations in children presenting with their first febrile convulsion. Arch Dis Child. 1977 Mar;52(3):188–191. doi: 10.1136/adc.52.3.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Valmari P., Mäkelä M., Kataja M., Peltola H. Multivariate prognostication in bacterial meningitis of childhood. Scand J Infect Dis. 1987;19(1):29–34. doi: 10.3109/00365548709032374. [DOI] [PubMed] [Google Scholar]
- Valmari P. White blood cell count, erythrocyte sedimentation rate and serum C-reactive protein in meningitis: magnitude of the response related to bacterial species. Infection. 1984 Sep-Oct;12(5):328–330. doi: 10.1007/BF01651146. [DOI] [PubMed] [Google Scholar]