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Extremity pain and refusal to walk in children with invasive meningococcal disease

Stanley H Inkelis1, Daniel O'Leary, Vincent J Wang

  • 1Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, California 90509, USA. inkelis@emedharbor.edu

Pediatrics
|July 3, 2002
PubMed

Insights

Extremity pain or refusal to walk occurs in 16% of children with invasive meningococcal disease. These symptoms can help identify cases of otherwise unsuspected meningococcal disease in children.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Early recognition of invasive meningococcal disease (IMD) in children can be challenging.
  • Extremity symptoms, such as pain or refusal to walk, are infrequently reported in pediatric IMD cases.

Purpose of the Study:

  • To determine the frequency of extremity symptoms in children with IMD.
  • To assess if extremity symptoms aid in identifying children with otherwise unsuspected IMD.

Main Methods:

  • Retrospective review of medical records for patients under 20 years with IMD (1985-1996).
  • Identification and description of children with extremity symptoms.
  • Comparison of clinical/laboratory findings and outcomes between children with and without extremity symptoms.

Main Results:

  • Out of 274 IMD patients, 45 (16%) presented with extremity symptoms (pain or refusal to walk).
  • Patients with extremity symptoms were older and had lower temperatures but higher band counts.
  • No significant differences in rash, WBC, coagulation, meningitis, or adverse outcomes were noted between groups.

Conclusions:

  • Extremity symptoms are present in 16% of pediatric IMD cases at diagnosis.
  • These symptoms may serve as a crucial indicator for diagnosing otherwise unsuspected invasive meningococcal disease in children.
Abstract

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