Revista Cubana de Pediatría
On-line version ISSN 1561-3119
DIAZ ALVAREZ, Manuel; CLAVER ISAS, Daniel and ARANGO ARIAS, María Isabel. Assessment protocol criteria of the febrile newborn without signs of meningitis-associated focalization. Rev Cubana Pediatr [online]. 2010, vol.82, n.4, pp. 1-12. ISSN 1561-3119.
INTRODUCTION. The aim of present research was to set which clinical or laboratory criteria of the method to assess the severe bacterial infection (SBI) risk allow to discriminate more likely those febrile newborns (NB) without focalizations signs (WFS) presenting with meningitis. METHODS. A retrospective study was conducted in 438 febrile NB admitted during 40 months. Study variables included the assessment criteria of SBI risk and the association of these variables for the NB group without neither type of SBI nor aseptic meningitis (AM) compared with those presenting with bacterial meningitis and with AM separately. RESULTS. Frequency of BM and of AM was of 2,5 and 9,3%, respectively. Except for the positive cyturia and the perinatal positive backgrounds of sepsis, remainder clinical and laboratory variables used to assess the risk of SBI of febrile NB WFS were associated to presence of BM. Fever ≥ 39ºC or persistent fever or recurrent was associated significantly with a AM. CONCLUSIONS. Diagnosis of meningitis (aseptic or bacterial) is common in febrile NB-SSF verifying that fever ≥39ºC and the persistent or recurrent fever are elements associated with presence of meningitis, thus, when they are present must to verify the possibility of some of these infections. Because of BM is the infection of worse prognosis also we must to take into account the other criteria related particularly to presence of a infectious toxic state.
Keywords : Severe bacterial infection; newborns; bacterial meningitis; aseptic meningitis; risk factors; assessment.