Tesoro and Selbst reviewed prognostic factors in pediatric meningococcal infections, and offered an updated modification of the score proposed by Stiehm and Damrosch.
Patient population
(1) children in Philadelphia, from 1 month to 15 years of age
(2) retrospective analysis of charts over an 8 year period
(3) included both meningococcal septicemia and/or meningitis
Differences from Stiehm and Damrosch:
(1) The absence of meningitis did not correlate with a worse outcome in their study population.
(2) Data on erythrocyte sedimentation rates was not often available.
(3) A normal WBC count was not associated with a poor outcome.
Predictors of poor outcome:
(1) nonblanching rash with petechiae or purpura
(2) presence of shock (systolic blood pressure undefined)
(3) low peripheral leukocyte count (<= 5,000 per µL)
(4) altered mental status at presentation, particularly obtundation or coma
prognostic score =
= SUM (number of poor outcome predictors present)
Interpretation:
• minimum score: 0
• maximum score: 4
• mortality rate by score not reported
Specialty: Infectious Diseases, Pulmonology, Neurology
ICD-10: ,