PEDIATRIC MENINGITIS CASE STUDIES

Course overview

Meningitis in children is a high-risk diagnosis, especially for physicians providing acute or episodic care. Medical errors may lead to profound disability or death. In addition, lawsuits in this arena are exceptionally costly, and there is no indication that recent changes in the malpractice climate will bring the situation under control. Although meningitis has declined significantly since the introduction of the Hemophilus influenza vaccine in the late 1980s, bacterial meningitis continues to occur. Recent analysis of data from large hospital organizations and insurance companies confirms that the failure to diagnose meningitis remains a high risk and a cause of high litigation cost in the practice of acute care medicine. In the evaluation of febrile pediatric patients, it is critical for practitioners to detect those children with meningitis or serious bacterial infection. In this activity, we present three cases involving children that either had or developed meningitis to illustrate some of the most common reasons the diagnosis of meningitis is delayed, missed, or inappropriately managed. After completing this activity, practitioners should be able to: interpret the signs and symptoms of meningitis in febrile pediatric patients; discuss the importance of documentation in cases of possible meningitis; and relate the significance of vital signs in the evaluation of febrile children.