Guidelines help diagnose severe meningitis-study

CHICAGO, Jan 3 (Reuters) Doctors can follow a set of guidelines to identify sick children who might have a deadly form of meningitis, sparing young patients days in the hospital, researchers said.

Meningitis produces swelling of the membranes surrounding the brain and spinal cord. The bacterial form that occurs in one in 25 cases can produce a more severe illness than the viral form.

Doctors often cannot determine which type of meningitis a patient has until a bacterial culture is produced in the laboratory -- requiring up to a three-day wait. Just in case, most patients are admitted to the hospital and treated with powerful antibiotics.

But guidelines developed four years ago and recently tested in a trial of 3,300 patients aged 29 days to 19 years correctly classified all but two patients, both of whom were younger than 2 months and more difficult to diagnose, according to the study published in this week's issue of the Journal of the American Medical Association.

The criteria include routine tests of blood and fluids and a checklist, including whether the child has had seizures since falling ill.

''The ability to identify those children who are at very low risk of bacterial meningitis and can be considered for management on an outpatient basis will avoid unnecessary hospitalization and aggressive antibiotic therapy,'' said study author Dr. Nathan Kuppermann of the University of California-Davis Medical Center.

A vaccine to combat bacterial meningitis has been recommended in the United States for at-risk children younger than 2 since 2000, reducing the incidence of the disease, the report said.

''The finding is important because it gives emergency room physicians nationwide a tool to guide their decision-making when caring for children with suspected meningitis, a serious and potentially life-threatening infection,'' said study co-author Lise Nigrovic of Children's Hospital Boston.

Reuters DH V0435