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Urgent full blood count in children over 3 months of age with bacterial meningitis

F A Riordan1, A P Thomson, J A Sills

  • 1Institute of Child Health, University of Liverpool, UK.

Journal of Accident & Emergency Medicine
|June 1, 1995
PubMed

Insights

Urgent full blood counts (FBC) in children with bacterial meningitis rarely aid immediate management. Conscious level is a more accurate predictor of outcome than FBC results.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hematology

Background:

  • Bacterial meningitis is a serious childhood infection.
  • Full blood count (FBC) is a common urgent test on admission.
  • The utility of urgent FBC in pediatric meningitis management is unclear.

Purpose of the Study:

  • To determine if urgent FBC results aid immediate management of pediatric meningitis.
  • To assess if urgent FBC predicts patient outcomes in pediatric meningitis.

Main Methods:

  • Retrospective analysis of 190 pediatric bacterial meningitis episodes (1984-1991).
  • Evaluation of FBC parameters, including anemia and white blood cell count.
  • Comparison of FBC findings with patient outcomes and Glasgow Coma Score (GCS).

Main Results:

  • Significant anemia was present in 7 children, requiring transfusion in 3 admitted to the Pediatric Intensive Care Unit (PICU).
  • Low white blood cell count (<5 x 10^9 L-1) was associated with death (P < 0.02).
  • Glasgow Coma Score < 8 was a more accurate predictor of death (40% positive predictive value) than FBC.

Conclusions:

  • Urgent FBC provided immediate clinical value in only 15% of pediatric meningitis cases, primarily those in the PICU.
  • Patient's conscious level (GCS) is a superior predictor of outcome compared to FBC.
  • Recommend urgent FBC for children with meningitis in PICU; others can have FBC analyzed during routine hours.

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