Nomogram of Koomen et al for Predicting Hearing Loss in a Pediatric Patient Following Bacterial Meningitis

Description

Koomen et al developed a nomogram for predicting the risk of hearing loss in a school aged child with bacterial meningitis. This can help identify patients who should undergo careful screening upon recovery. The authors are from VU Medical Center Amsterdam and University Medical Center Utrecht in the Netherlands.

Parameters (with values extracted from the nomogram in Figure 1, page 1052):

(1) duration of symptoms

(2) petechiae

(3) CSF glucose

(4) presence of Streptococcus pneumoniae

(5) ataxia

Parameter	Finding	Points
duration of symptoms	<= 2 days	0
	> 2 days	10.1
petechiae	absent	27.4
	present	0
CSF glucose	<= 0.6 mmol/L	15
	> 0.6 mmol/L (10.8 mg/dL)	0
Streptococcus pneumoniae	absent	0
	present	12.4
ataxia	absent	0
	present	36.1

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 101

• The higher the score the higher the risk of deafness.

Points	Percent with Hearing Loss
< 3.5	< 1%
3.5 to 60.4	(0.000168 * ((points)^3)) - (0.004536 * ((points)^2)) + (0.151 * (points)) + 0.5210
60.4 to 79.6	(1.565 * (points)) - 64.65
79.6 to 118.9	(-0.01731 * ((points)^2)) + (4.323 * (points)) - 174.4
> 118.9	> 95%

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Nomogram of Koomen et al for Predicting Hearing Loss in a Pediatric Patient Following Bacterial Meningitis

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