Description

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

 


To read more or access our algorithms and calculators, please log in or register.