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Nancy Gary, MS; Nancy Powers, PsyD; James K. Todd, MD

Am J Dis Child. 1989;143(3):307-311.

Abstract
• One hundred ninety-five consecutive children with Haemophilus influenzae meningitis were retrospectively reviewed to identify those patients at high risk of death or severe sequelae using a previously described clinical scoring system. One hundred sixty-nine children (86.7%) had prognostic scores less than or equal to 4.0 and all survived. Twenty-six patients (13.3%) had prognostic scores greater than or equal to 4.5 points. Five of these high-risk patients (2.6% overall) died as a direct result of their acute meningitis. Of the remaining 21 survivors, 15 were available for prospective, observer-blinded, follow-up evaluation, as compared with 15 low-risk control patients matched for age, sex, and year of admission. High-risk patients were significantly more likely to have more serious sequelae (2.0± 2.1) as compared with low-risk controls (0.5 ±0.7). Those high-risk patients who by the choice of their treating physicians had received corticosteroids (and usually osmotic therapy as well) appeared to have outcomes similar to their matched lowrisk controls and significantly better than those high-risk patients who did not receive such additional therapy.

(AJDC.1989;143:307-311)

Author Affiliations
From The Children's Hospital Kempe Research Center, The Children's Hospital of Denver (Mss Gary and Powers and Dr Todd), Departments of Pediatrics (Ms Gary and Dr Todd) and Microbiology/Immunology (Dr Todd), University of Colorado School of Medicine, Denver.

Footnotes
Accepted for publication November 21, 1988.

Reprint requests Children's Hospital, 1056 E 19th Ave, Denver, CO 80218 (Dr Todd).

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