Can Clinical Presentations or Hematological Indices Predict Meningitis in Febrile Children?

The aim of this study is to assess the role of clinical presentations and hematological indices in the diagnosis of meningitis in febrile children during a meningitis outbreak. A cross-sectional study, recruiting (236) febrile children underwent lumbar puncture for suspected meningitis. Participants were divided into two groups based on the results of cerebrospinal fluid (CSF) analysis: the case group included all those who carried a diagnosis of meningitis while the rest of the patients whose CSF analysis result was negative for meningitis was taken as a control group. The clinical characteristics, hematological indices were compared between both groups. Children with proved meningitis were significantly of older age and resides more in rural areas than control P value= (0.001), (0.014) respectively. The Neutrophil to lymphocyte ratio and platelet counts were the only significant hematological indices that elevated in children with meningitis P value= (0.001), (0.018) respectively. Headache and neck stiffness were documented more in children with meningitis P value = (<0.001) whilst seizure was significantly less common in children with meningitis P value = (<0.001). During a meningitis outbreak, pediatrician in low resource country can use a constellation of clinical and hematological characteristics to identify febrile children who in need of lumbar puncture to exclude meningitis.