Subjects
- The algorithm was derived from 1072 Chinese neonates aged 0-28 days suspected of cental nervous system infection and accepted lumbar puncture.
- Neonate bacterial meningitis was confirmed by pathogenic bacteria investigation and lumber puncture.
How to use
- After entering measurements of fever (Yes, No), definite source of infection (Yes, No), neurological manifestation (Yes, No), CRP (mg/L) and PCT (ng/dl), the risk stratification of neonate bacterial meningitis was automatically classified as at high risk and low risk according to the sequential algorithm presented at the bottom of the webpage.
- If a patient is at high risk, he/she is strongly suggested to administrate lumbar puncture.
- If a patient is at low risk, lumbar puncture is not urgent , and a short-term observation and reassessment in the management of these patients may be more appropriate.
Note
- Fever: temperature＞38℃
- Neurological manifestation: present one or more signs including seizure, abnormal tension, irritability, and bulging anterior fontanelle.
- Definite source of bacterial infection: with any source of infection as follows: impetigo, urinary tract infection (UTI), omphalitis, respiratory infection, and purulent arthritis.
- CRP and PCT should be administrated within 24 hours on admission.
- Patients older than 28 days or with traumatic LP or with antibiotic pretreatment are not applicable to this calculator.
Algorithm
| The Sequential algorithm |
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Presence fever with a definite source of infection?
No: with fever but absence of infection source.
Yes: with fever and definite source of infection. |
Chen et al, Derivation and validation of a Sequential Approach to Identify Full-term Neonates at Low Risk of Bacterial Meningitis.
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