TY - JOUR
T1 - Delays in Diagnosis and Treatment of Bacterial Meningitis in NYC
T2 - Retrospective Cohort Analysis
AU - Torres, Sarah D.
AU - Kim, Carla Y.
AU - Das, Mitashee
AU - Ankam, Jyoti V.
AU - Luche, Nicole
AU - Harmon, Michael
AU - Schorr, Emily M.
AU - Glassberg, Brittany
AU - Morse, Stephen S.
AU - Weiss, Don
AU - Gofshteyn, Jacqueline S.
AU - Yeshokumar, Anusha K.
AU - Thakur, Kiran T.
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Jacqueline Gofshteyn is supported by the NIH/NINDS NSADA-K12 Career Development Award (NS5250799523). Kiran Thakur is supported by the National Institute of Health, NINDS K23 NS105935-01 and NIH/NICHD 1R01HD074944-01A1.
Publisher Copyright:
© The Author(s) 2021.
PY - 2022/4
Y1 - 2022/4
N2 - Community-acquired bacterial meningitis (CABM) morbidity and mortality remains high in those infected. Rapid diagnosis and treatment is paramount to reducing mortality and improving outcome. This retrospective cohort study aims to assess the time from presentation to diagnosis and treatment of vaccine preventable CABM as well as identify possible factors associated with delays in diagnosis and antibiotic administration. A retrospective chart review was conducted of individuals who presented to Columbia University Irving Medical Center (CUIMC), Children’s Hospital of New York (CHONY), Mount Sinai Medical Center, and Weill Cornell Medical Center with BM due to Haemophilus influenzae type B, Streptococcus pneumoniae, and Neisseria meningitidis between January 1, 2012 and December 31, 2017. Diagnosis was delayed by more than 8 hours in 13 patients (36.1%) and 5 individuals (13.9%) had a delay of 4 hours or more from presentation to the administration of antibiotics with appropriate CNS coverage. All of these patients were also initially misdiagnosed at an outpatient clinic, outside hospital, or emergency department. This retrospective study identified febrile and/or viral infections not otherwise specified and otitis media as the most common misdiagnoses underlying delays from presentation to diagnosis and to antibiotic treatment in those with BM.
AB - Community-acquired bacterial meningitis (CABM) morbidity and mortality remains high in those infected. Rapid diagnosis and treatment is paramount to reducing mortality and improving outcome. This retrospective cohort study aims to assess the time from presentation to diagnosis and treatment of vaccine preventable CABM as well as identify possible factors associated with delays in diagnosis and antibiotic administration. A retrospective chart review was conducted of individuals who presented to Columbia University Irving Medical Center (CUIMC), Children’s Hospital of New York (CHONY), Mount Sinai Medical Center, and Weill Cornell Medical Center with BM due to Haemophilus influenzae type B, Streptococcus pneumoniae, and Neisseria meningitidis between January 1, 2012 and December 31, 2017. Diagnosis was delayed by more than 8 hours in 13 patients (36.1%) and 5 individuals (13.9%) had a delay of 4 hours or more from presentation to the administration of antibiotics with appropriate CNS coverage. All of these patients were also initially misdiagnosed at an outpatient clinic, outside hospital, or emergency department. This retrospective study identified febrile and/or viral infections not otherwise specified and otitis media as the most common misdiagnoses underlying delays from presentation to diagnosis and to antibiotic treatment in those with BM.
KW - bacterial meningitis
KW - central nervous system infection
KW - diagnosis
KW - misdiagnoses
KW - neurological sequelae
KW - vaccine preventable
UR - http://www.scopus.com/inward/record.url?scp=85113533995&partnerID=8YFLogxK
U2 - 10.1177/19418744211037319
DO - 10.1177/19418744211037319
M3 - Article
AN - SCOPUS:85113533995
VL - 12
SP - 268
EP - 272
JO - The Neurohospitalist
JF - The Neurohospitalist
SN - 1941-8744
IS - 2
ER -