Predictors of Meningitis in Febrile Infants Aged 3 Months or Younger / 소아감염

ABSTRACT

PURPOSE:The purpose of this study was to identify useful predictors for diagnosing bacterial meningitis and performing CSF studies in febrile infants three months or younger. METHODS:Six hundred and fifty two febrile infants with a rectal temperature > or =38.0 degreesC presented from January 2003 to April 2008 and were retrospectively studied. The total white blood cell count (WBC), band count, absolute neutrophil count (ANC), quantitative C-reactive protein (CRP) and blood cultures were performed on admission. The clinical variables associated with bacterial meningitis were analyzed. RESULTS:In patients with bacterial meningitis, the clinical variables including CRP (P= 0.036), band count (P=0.037), ANC (P=0.036) and age (P=0.001) were significantly different. The area under the receiver-operating characteristic curve was 0.969 for CRP, 0.946 for the band count, 0.765 for the ANC and 0.235 for age. A CRP cutoff point of 8 mg/dL was determined to maximize both the sensitivity and specificity (sensitivity 83%, specificity 95%, likelihood ratio 16.6). A CRP concentration of or =9 mg/dL increased the clinical suspicion of bacterial meningitis and the need for CSF evaluation.