Pediatric bacterial meningitis: is prior antibiotic therapy associated with an altered clinical presentation?

Abstract:

STUDY HYPOTHESIS:The clinical features of children treated with oral antibiotics before the diagnosis of bacterial meningitis differ from those who receive no antibiotics. DESIGN:Retrospective case series. SETTING:University medical center. PARTICIPANTS:Two hundred fifty-eight children 24 months old or younger with bacterial meningitis hospitalized during a 12-year period. Eighty-three children were treated with oral antibiotics before the diagnosis of meningitis, and 175 children were not. INTERVENTIONS:None. METHODS:The emergency department chart and hospital records were reviewed for presenting demographic, historical, physical examination, and laboratory features. Clinical features of pretreated and untreated patients were compared. RESULTS:Pretreated children demonstrated less frequent temperature of 38.3 C or higher, altered mental status and a longer duration of symptoms before diagnosis, with more frequent vomiting; ear, nose, and throat infections; and physician visits in the week before detection of meningitis (P less than .05 for all comparisons). There was no difference in incidence of upper respiratory symptoms, seizures, nuchal rigidity, Kernig's and Brudzinski's signs, focal neurologic signs, mortality, and length of hospitalization between groups. CONCLUSION:Clinical features of children who have taken antibiotics before the detection of meningitis differ significantly from those who have not undergone antibiotic therapy. Physicians should be aware of these differences when evaluating young children on antibiotics for the possibility of meningitis.

journal_name

Ann Emerg Med

authors

Rothrock SG,Green SM,Wren J,Letai D,Daniel-Underwood L,Pillar E

doi

10.1016/s0196-0644(05)80149-0

subject

Has Abstract

pub_date

1992-02-01 00:00:00

pages

146-52

issue

2

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(05)80149-0

journal_volume

21

pub_type

杂志文章
  • Night shift work.

    abstract::The deleterious effects of night shift work are discussed in relation to emergency physicians. Much of the early research is drawn from heavy industry sources and must be extrapolated to medical work. Disruption of circadian rhythms and Zeitgebers, caused by adherence to contemporary social schedules, causes recurrent...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(84)80615-0

    authors: Michaels HE

    更新日期:1984-03-01 00:00:00

  • Intestinal evisceration resulting from a motor vehicle accident.

    abstract::Presented is the case of a motor vehicle accident (MVA) victim with hypotension and evisceration of small intestine. Vigorous resuscitation in the emergency department was required, after which a portion of small bowel was resected at laparotomy. Evisceration secondary to trauma in an MVA is a rare injury. Significant...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(84)80296-6

    authors: Majernick TG,West JC,Snover W,Brotman S

    更新日期:1984-08-01 00:00:00

  • Initial test of emergency procedure performance in temporary negative pressure isolation by using simulation technologies.

    abstract:STUDY OBJECTIVE:The potential of infectious disease spread in diseases such as tuberculosis, infectious disease epidemic such as avian flu and the threat of terrorism with agents capable of airborne transmission have focused attention on the need for increased surge capacity for patient isolation. Total negative pressu...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2007.04.017

    authors: Davis MA,Landesman R,Tadmor B,Hopmeier M,Shenhar G,Barker T,Pozner CN,Binstadt ES,Nelson S,Look R,Shubina M,Walls RM

    更新日期:2008-04-01 00:00:00

  • Acute drug overdose: one hospital's experience.

    abstract::A retrospective review of all patients admitted to an urban teaching hospital emergency department with the complaint of overdose, poisoning, or ingestion during a 10-month period was conducted. Analysis of these 82 episodes involving 69 individuals revealed: 1) a preponderance of women in the 20- to 40-year old range...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(81)80453-2

    authors: Soslow AR

    更新日期:1981-01-01 00:00:00

  • Local media influence on opting out from an exception from informed consent trial.

    abstract:STUDY OBJECTIVE:News media are used for community education and notification in exception from informed consent clinical trials, yet their effectiveness as an added safeguard in such research remains unknown. We assessed the number of callers requesting opt-out bracelets after each local media report and described the ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2009.05.028

    authors: Nelson MJ,DeIorio NM,Schmidt T,Griffiths D,Daya M,Haywood L,Zive D,Newgard CD

    更新日期:2010-01-01 00:00:00

  • Shoulder pain and pneumoperitoneum following a diving accident.

    abstract::We present the case of a diver who experienced the acute onset of shoulder pain after a rapid ascent. It was determined that the patient had decompression sickness ("the bends") of the right shoulder and pulmonary barotrauma resulting in secondary pneumoperitoneum. He underwent decompression, with prompt resolution of...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(87)80240-8

    authors: Schriger DL,Rosenberg G,Wilder RJ

    更新日期:1987-11-01 00:00:00

  • Controversies in out-of-hospital emergency airway control: esophageal obstruction or endotracheal intubation?

    abstract::Maintaining an unobstructed airway and providing adequate oxygenation and CO2 elimination, by artificial means if necessary, are among the highest priorities in all life-threatening circumstances. How this goal can best be met in the prehospital setting has become a controversial issue. The esophageal obturator airway...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(84)80434-5

    authors: White RD

    更新日期:1984-09-01 00:00:00

  • A rational approach to shift work in emergency medicine.

    abstract::As the only medical specialists who routinely provide continuous 24-hour daily coverage, emergency physicians are all too familiar with the demands of shift work. Although shift work has a pervasive effect on the practice of emergency medicine and is regarded as a major stressor, it has received little attention per s...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(05)81758-5

    authors: Whitehead DC,Thomas H Jr,Slapper DR

    更新日期:1992-10-01 00:00:00

  • Training with video imaging improves the initial intubation success rates of paramedic trainees in an operating room setting.

    abstract:STUDY OBJECTIVE:Video imaging of intubation as seen by the laryngoscopist has not been a part of traditional instruction methods, and its potential impact on novice intubation success rates has not been evaluated. METHODS:We prospectively tracked the success rates of novice intubators in paramedic classes who were req...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2001.111516

    authors: Levitan RM,Goldman TS,Bryan DA,Shofer F,Herlich A

    更新日期:2001-01-01 00:00:00

  • A randomized, controlled trial of the use of music during laceration repair.

    abstract:STUDY OBJECTIVES:To determine whether music significantly reduces the pain and anxiety associated with laceration repair in the emergency department. PARTICIPANTS AND SETTING:Adult patients presenting to the ED at an urban teaching hospital for laceration repair. Exclusion criteria included patients less than 18 years...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0196-0644(05)81652-x

    authors: Menegazzi JJ,Paris PM,Kersteen CH,Flynn B,Trautman DE

    更新日期:1991-04-01 00:00:00

  • Early detection of illness associated with poisonings of public health significance.

    abstract::Since September 11, 2001, concern about potential terrorist attacks has increased in the United States. To reduce morbidity and mortality from outbreaks of illness from the intentional release of chemical agents, we examine data from the Toxic Exposure Surveillance System (TESS). TESS, a national system for timely col...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2005.09.016

    authors: Wolkin AF,Patel M,Watson W,Belson M,Rubin C,Schier J,Kilbourne EM,Crawford CG,Wattigney W,Litovitz T

    更新日期:2006-02-01 00:00:00

  • Are rotating tourniquets useful for left ventricular preload reduction in patients with acute myocardial infarction and heart failure?

    abstract::We examined the hemodynamic effects of congesting cuffs (rotating tourniquets) in 12 patients with first acute myocardial infarction and new onset of congestive heart failure 24 to 48 hours after admission. Congesting cuffs were applied for two periods of 15 minutes each, 15 minutes apart, and inflated to 30 mm Hg and...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(87)80570-x

    authors: Roth A,Hochenberg M,Keren G,Terdiman R,Laniado S

    更新日期:1987-07-01 00:00:00

  • Immunologic response to tetanus toxoid in geriatric patients.

    abstract:STUDY OBJECTIVE:Tetanus antibody levels have been shown to be inadequate in 50% of patients older than 65 years. Although immunization recommendations have been made for this age group, the efficacy of this intervention has not been well documented. We sought to determine the difference in tetanus antibody levels after...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(97)70005-2

    authors: Alagappan K,Rennie W,Narang V,Auerbach C

    更新日期:1997-10-01 00:00:00

  • Emergency medicine in the Bahamas.

    abstract::The Bahamas is an archipelago of 700 islands with the majority of the population concentrated on just 2 islands: New Providence and Grand Bahama. Most emergency medical services are provided by Princess Margaret Hospital and Rand Memorial Hospital located respectively on those 2 islands. A detailed description of the ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2001.118865

    authors: Ezenkwele UA,Burnett-Garraway C,Green GB

    更新日期:2001-12-01 00:00:00

  • Impact of Urgent Care Openings on Emergency Department Visits to Two Academic Medical Centers Within an Integrated Health Care System.

    abstract:STUDY OBJECTIVE:The effect of urgent cares on local emergency department (ED) patient volumes is presently unknown. In this paper, we aimed to assess the change in low-acuity ED utilization at 2 academic medical centers in relation to patient proximity to an affiliated urgent care. METHODS:We created a geospatial data...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2019.06.024

    authors: Carlson LC,Raja AS,Dworkis DA,Lee J,Brown DFM,Samuels-Kalow M,Wilson M,Shapiro M,Kim J,Yun BJ

    更新日期:2020-03-01 00:00:00

  • Angiotensin II effects in a swine model of cardiac arrest.

    abstract:STUDY OBJECTIVE:To evaluate the effect of different doses of the vasopressor angiotensin II on aortic diastolic and coronary perfusion pressures in a swine model of cardiac arrest. DESIGN:Immature swine were anesthetized and hemodynamically monitored. Ventricular fibrillation was induced; CPR was begun after ten minut...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)80213-6

    authors: Little CM,Hobson JL,Brown CG

    更新日期:1993-02-01 00:00:00

  • Needlestick injuries and hepatitis B immunization in Florida paramedics: a statewide survey.

    abstract:STUDY OBJECTIVES:To determine the incidence of needlestick injury among paramedics working in Florida during 1987, to describe the circumstances surrounding such injuries, and to assess the hepatitis B vaccination status of this group. DESIGN:Survey of a systematic random sample of paramedics using a self-administered...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)81072-8

    authors: Klontz KC,Gunn RA,Caldwell JS

    更新日期:1991-12-01 00:00:00

  • The time dependence of antithrombin initiation in patients with non-ST-segment elevation acute coronary syndromes: subgroup analysis from the ACUITY trial.

    abstract:STUDY OBJECTIVE:Antithrombins are among standard treatment agents for patients with non-ST-segment elevation acute coronary syndromes. We aimed to determine the association between time from emergency department (ED) presentation to treatment with an antithrombin and adverse cardiac events. METHODS:The study cohort wa...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.annemergmed.2010.06.567

    authors: Diercks DB,Pollack CV Jr,Hollander JE,Blomkalns AL,Emerman CL,Rokos IC,Larson DM,Hoekstra JW,Mehran R,Stone GW

    更新日期:2011-03-01 00:00:00

  • Emergency department management of blood and body fluid exposures.

    abstract::Exposure to blood and body fluids that may be contaminated with infectious agents is a common occupational hazard for health care workers. Health care workers in the emergency department or out-of-hospital setting are at especially high risk for exposure to blood or body fluids. Nonemergency health care workers are fr...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(00)70104-1

    authors: Moran GJ

    更新日期:2000-01-01 00:00:00

  • WITHDRAWN: Comparison of Preadministered and Coadministered Lidocaine for Treating Pain and Distress Associated With Intranasal Midazolam Administration in Children: A Randomized Clinical Trial.

    abstract::This article has been withdrawn at the request of the authors and editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal. ...

    journal_title:Annals of emergency medicine

    pub_type: 撤回出版物

    doi:10.1016/j.annemergmed.2020.04.025

    authors: O'Connell NC,Woodward HA,Flores-Sanchez PL,McLaren SH,Ieni M,McKinley KW,Shen ST,Dayan PS,Tsze DS

    更新日期:2020-06-02 00:00:00

  • Comparison of electronic pharmacy prescription records with manually collected medication histories in an emergency department.

    abstract:STUDY OBJECTIVE:Medication history is an essential part of patient assessment in emergency care. Patient-reported medication history can be incomplete. We study whether an electronic pharmacy-sourced prescription record can supplement the patient-reported history. METHODS:In a community hospital, we compared the patie...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2013.04.014

    authors: Fung KW,Kayaalp M,Callaghan F,McDonald CJ

    更新日期:2013-09-01 00:00:00

  • Refusing care to emergency department of patients: evaluation of published triage guidelines.

    abstract:STUDY OBJECTIVE:To determine whether a set of published triage guidelines identifies patients who can safely be refused emergency department care. DESIGN:Historical cohort study. SETTING:A public hospital ED. TYPE OF PARTICIPANTS:All patients triaged during a one-week period who were not in the most acute triage cat...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(94)70042-7

    authors: Lowe RA,Bindman AB,Ulrich SK,Norman G,Scaletta TA,Keane D,Washington D,Grumbach K

    更新日期:1994-02-01 00:00:00

  • Acute epiglottitis in adults.

    abstract::Epiglottitis in adults, while uncommon, is certainly not rare. Despite the increasing reports of the disorder in the literature, it continues to be misdiagnosed in emergency departments. The first step in the diagnosis of acute epiglottitis is for the emergency physician to think of it. The literature concerning the e...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(81)80463-5

    authors: Sarant G

    更新日期:1981-01-01 00:00:00

  • Injury control in Honduras: a survey of injury mortality.

    abstract:STUDY OBJECTIVE:We sought to evaluate the methods and accuracy of mortality data collection and summarize the injury mortality rate in one sector of the State of Olancho, Honduras, with the intent to establish a baseline of injury mortality that will identify potential areas of intervention and serve as a comparison af...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1067/mem.2000.109444

    authors: Richman M,Shayne P,Heron S,Lowery D,Todd KH

    更新日期:2000-10-01 00:00:00

  • Detecting acute thoracic aortic dissection in the emergency department: time constraints and choice of the optimal diagnostic test.

    abstract:STUDY OBJECTIVES:To compare diagnostic strategies for the emergency assessment of patients with suspected acute thoracic aortic dissection and to measure the effect of delays related to the availability of these tests on the selection of the most appropriate one. METHODS:We carried out a decision analysis representing...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(96)70026-4

    authors: Sarasin FP,Louis-Simonet M,Gaspoz JM,Junod AF

    更新日期:1996-09-01 00:00:00

  • Outcome of Immediate Versus Early Antibiotics in Severe Sepsis and Septic Shock: A Systematic Review and Meta-analysis.

    abstract:STUDY OBJECTIVE:Debate exists about the mortality benefit of administering antibiotics within either 1 or 3 hours of sepsis onset. We performed this meta-analysis to analyze the effect of immediate (0 to 1 hour after onset) versus early (1 to 3 hours after onset) antibiotics on mortality in patients with severe sepsis ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,meta分析

    doi:10.1016/j.annemergmed.2020.04.042

    authors: Rothrock SG,Cassidy DD,Barneck M,Schinkel M,Guetschow B,Myburgh C,Nguyen L,Earwood R,Nanayakkara PWB,Nannan Panday RS,Briscoe JG

    更新日期:2020-10-01 00:00:00

  • Risk factors for apnea in pediatric patients transported by paramedics for out-of-hospital seizure.

    abstract:STUDY OBJECTIVE:Apnea is a known complication of pediatric seizures, but patient factors that predispose children are unclear. We seek to quantify the risk of apnea attributable to midazolam and identify additional risk factors for apnea in children transported by paramedics for out-of-hospital seizure. METHODS:This i...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2013.09.015

    authors: Bosson N,Santillanes G,Kaji AH,Fang A,Fernando T,Huang M,Lee J,Gausche-Hill M

    更新日期:2014-03-01 00:00:00

  • American Board of Emergency Medicine Report on Residency Training Information (2015-2016).

    abstract::The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency programs and the residents training in those programs. We present the 2016 annual report on the status of US emergency medicine training programs. ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/j.annemergmed.2016.03.031

    authors: Marco CA,Baren JM,Beeson MS,Carius ML,Counselman FL,Gausche-Hill M,Goyal DG,Kowalenko T,Muelleman RL,Nelson LS,Wahl RP,Joldersma KB,Research Committee, American Board of Emergency Medicine.

    更新日期:2016-05-01 00:00:00

  • Emergency thrombolysis in acute myocardial infarction.

    abstract::The goal of thrombolytic treatment in acute myocardial infarction is to reestablish permanent blood flow, salvage ischemic myocardium, and reduce mortality. If patency is achieved sufficiently early and is maintained, left ventricular function is preserved and mortality decreases. The recent experience with tissue pla...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0196-0644(88)80063-5

    authors: Heras M,Chesebro JH,Gersh BG,Holmes DR,Mock MB,Fuster V

    更新日期:1988-11-01 00:00:00

  • Interposed abdominal compression-CPR: a case study in cardiac arrest research.

    abstract::When the abdomen is compressed manually in counterpoint to the rhythm of chest compression, in the performance of interposed abdominal compression-CPR, artificial circulation is approximately doubled in animal experiments and in electronic models of the circulatory system. These studies suggest that external manual co...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章

    doi:10.1016/s0196-0644(05)80245-8

    authors: Babbs CF

    更新日期:1993-01-01 00:00:00