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Feber og hudblødninger hos børn--er det meningokoksygdom?

Nielsen, Hans Erik; Andersen, Erik Arthur; Andersen, Jesper; Böttiger, Blenda LU ; Christiansen, Karsten Maidahl; Daugbjerg, Peder Stjernholm; Larsen, Severin Olesen; Lind, Inga; Nir, Marta and Olofsson, Kern (2002) In Ugeskrift for Laeger 164(20). p.2617-2623
Abstract

INTRODUCTION: Our main aims were to establish criteria for early distinction between meningococcal disease and other conditions with similar clinical features, and to identify other causes of haemorrhagic rashes accompanied by fever.

MATERIALS AND METHODS: This prospective study comprised 264 infants and children hospitalised with fever and skin haemorrhages.

RESULTS: We identified an aetiological agent in 28%: 15% had meningococcal disease, 2% another invasive bacterial infection, 7% enterovirus infection, and 4% adenovirus infection. Five clinical variables discriminated meningococcal disease from other conditions on admission: skin haemorrhages of (1) characteristic appearance; (2) universal distribution and (3) a maximum... (More)

INTRODUCTION: Our main aims were to establish criteria for early distinction between meningococcal disease and other conditions with similar clinical features, and to identify other causes of haemorrhagic rashes accompanied by fever.

MATERIALS AND METHODS: This prospective study comprised 264 infants and children hospitalised with fever and skin haemorrhages.

RESULTS: We identified an aetiological agent in 28%: 15% had meningococcal disease, 2% another invasive bacterial infection, 7% enterovirus infection, and 4% adenovirus infection. Five clinical variables discriminated meningococcal disease from other conditions on admission: skin haemorrhages of (1) characteristic appearance; (2) universal distribution and (3) a maximum diameter of > 2 mm; (4) poor general condition; and (5) nuchal rigidity.

DISCUSSION: If any two or more of these clinical variables were present, the probability of identifying a patient with meningococcal disease was 97% and the false-positive rate was only 12%. This diagnostic algorithm did not identify children in whom septicaemia was caused by other bacterial species.

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Please use this url to cite or link to this publication:
author
alternative title
Fever and skin hemorrhages in children--is it meningococcal disease?
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Child, Child, Preschool, Diagnosis, Differential, Fever/diagnosis, Hemorrhage/diagnosis, Humans, Infant, Meningitis, Bacterial/diagnosis, Meningitis, Viral/diagnosis, Meningococcal Infections/diagnosis, Microbiological Techniques, Prospective Studies, Skin/pathology, Skin Diseases, Bacterial/diagnosis, Skin Diseases, Viral/diagnosis
in
Ugeskrift for Laeger
volume
164
issue
20
pages
7 pages
publisher
Den Almindelige Danske Lægeforening
external identifiers
  • scopus:4243381878
ISSN
0041-5782
language
Danish
LU publication?
no
id
ee39c04c-d015-438f-8f81-58d064c5da61
alternative location
http://ugeskriftet.dk/videnskab/feber-og-hudbloedninger-hos-boern-er-det-meningokoksygdom
date added to LUP
2019-05-02 14:31:35
date last changed
2019-05-09 15:37:03
@article{ee39c04c-d015-438f-8f81-58d064c5da61,
  abstract     = {<p>INTRODUCTION: Our main aims were to establish criteria for early distinction between meningococcal disease and other conditions with similar clinical features, and to identify other causes of haemorrhagic rashes accompanied by fever.</p><p>MATERIALS AND METHODS: This prospective study comprised 264 infants and children hospitalised with fever and skin haemorrhages.</p><p>RESULTS: We identified an aetiological agent in 28%: 15% had meningococcal disease, 2% another invasive bacterial infection, 7% enterovirus infection, and 4% adenovirus infection. Five clinical variables discriminated meningococcal disease from other conditions on admission: skin haemorrhages of (1) characteristic appearance; (2) universal distribution and (3) a maximum diameter of &gt; 2 mm; (4) poor general condition; and (5) nuchal rigidity.</p><p>DISCUSSION: If any two or more of these clinical variables were present, the probability of identifying a patient with meningococcal disease was 97% and the false-positive rate was only 12%. This diagnostic algorithm did not identify children in whom septicaemia was caused by other bacterial species.</p>},
  author       = {Nielsen, Hans Erik and Andersen, Erik Arthur and Andersen, Jesper and Böttiger, Blenda and Christiansen, Karsten Maidahl and Daugbjerg, Peder Stjernholm and Larsen, Severin Olesen and Lind, Inga and Nir, Marta and Olofsson, Kern},
  issn         = {0041-5782},
  keyword      = {Child,Child, Preschool,Diagnosis, Differential,Fever/diagnosis,Hemorrhage/diagnosis,Humans,Infant,Meningitis, Bacterial/diagnosis,Meningitis, Viral/diagnosis,Meningococcal Infections/diagnosis,Microbiological Techniques,Prospective Studies,Skin/pathology,Skin Diseases, Bacterial/diagnosis,Skin Diseases, Viral/diagnosis},
  language     = {dan},
  month        = {05},
  number       = {20},
  pages        = {2617--2623},
  publisher    = {Den Almindelige Danske Lægeforening},
  series       = {Ugeskrift for Laeger},
  title        = {Feber og hudblødninger hos børn--er det meningokoksygdom?},
  volume       = {164},
  year         = {2002},
}