Offringa M, Beishuizen A, Derksen-Lubsen G, Lubsen J
Department of Pediatrics, University Hospital Rotterdam, The Netherlands.
Clin Pediatr (Phila). 1992 Sep;31(9):514-22. doi: 10.1177/000992289203100901.
A study was done of 309 children seen in two ERs with a first seizure and fever to assess whether meningitis could be recognized using readily available clinical information. Among these children, 23 (7%) cases of meningitis were diagnosed. A group of 69 children with seizures and fever but no meningitis served as controls. Signs from ER examinations that discriminated between children with and those without meningitis were: petechiae, nuchal rigidity, coma, persistent drowsiness, ongoing convulsions, and paresis or paralysis; 21 cases were thus identified. Two children with a suspicious history but none of these signs proved to have meningitis. Children whose seizures showed no complex features and whose febrile illness revealed no suspicious features did not have meningitis. Our results indicate that based on available clinical data, meningitis can be ruled out in children presenting with seizures and fever; thus, there is no need for routine investigation of cerebrospinal fluid.
一项针对在两家急诊室就诊的309名首次癫痫发作且伴有发热的儿童开展的研究，旨在评估能否利用现有的临床信息来识别脑膜炎。在这些儿童中，确诊了23例（7%）脑膜炎病例。一组69名有癫痫发作和发热但无脑膜炎的儿童作为对照。急诊检查中能区分患脑膜炎儿童和未患脑膜炎儿童的体征有：瘀点、颈部强直、昏迷、持续嗜睡、持续性惊厥以及轻瘫或瘫痪；据此识别出了21例。两名有可疑病史但无上述任何体征的儿童被证实没有患脑膜炎。癫痫发作无复杂特征且发热疾病无可疑特征的儿童没有患脑膜炎。我们的结果表明，基于现有的临床数据，可以排除癫痫发作且伴有发热儿童患脑膜炎的可能；因此，无需常规进行脑脊液检查。
