Do All Children Who Present With a Complex Febrile Seizure Need a Lumbar Puncture?
Ann Emerg Med
; 70(1): 52-62.e6, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-28259480
ABSTRACT
STUDY OBJECTIVE:
We assess the prevalences of bacterial meningitis and herpes simplex virus meningoencephalitis (HSV-ME) in children with a complex febrile seizure and determine these prevalences in the subgroup of children with a clinical examination result not suggestive of meningitis or encephalitis.METHODS:
This multicenter retrospective study was conducted in 7 pediatric emergency departments (EDs) in the region of Paris, France. Visits of patients aged 6 months to 5 years for a complex febrile seizure from January 2007 to December 2011 were analyzed. We defined a subgroup of patients whose clinical examination result was not suggestive of meningitis or encephalitis. Bacterial meningitis and HSV-ME were sequentially sought for by analyzing bacteriologic and viral data at the visit, looking for data from a second visit to the hospital after the index visit, and telephoning the child's parents.RESULTS:
From a total of 1,183,487 visits in the 7 pediatric EDs, 839 patients presented for a complex febrile seizure, of whom 260 (31.0%) had a lumbar puncture. The outcomes bacterial meningitis and HSV-ME were ascertainable for 715 (85%) and 657 (78.3%) visits, respectively, and we found 5 cases of bacterial meningitis (0.7% [95% confidence interval [CI] 0.2% to 1.6%]) and no HSV-ME (0% [95% CI 0% to 0.6%]). Among the 630 visits of children with a clinical examination result not suggesting meningitis or encephalitis, we found no bacterial meningitis (0% [95% CI 0% to 0.7%]) and no HSV-ME (0% [95% CI 0% to 0.8%]).CONCLUSION:
In children with a complex febrile seizure, bacterial meningitis and HSV-ME are unexpected events when the clinical examination after complex febrile seizure is not suggestive of meningitis or encephalitis.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Punção Espinal
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Meningites Bacterianas
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Convulsões Febris
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Encefalite por Herpes Simples
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Serviço Hospitalar de Emergência
Tipo de estudo:
Guideline
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Infant
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Male
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article