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Tool 'may help' early meningitis diagnosis

14.09.10 

The most dangerous form of meningitis can kill within hours - but doctors think they have developed the best way to identify it early.

The "predictive model" developed by the Health Protection Agency could mean the right treatment is given quickly.

It uses a combination of blood tests and symptoms to help identify bacterial meningitis.

Meningitis is an inflammation in the membranes surrounding the spinal cord and brain. It is most often caused by either bacterial or viral infection.

Knowing which is which can make a big difference to the best treatment.

Bacterial meningitis needs antibiotic treatment as soon as possible - and it is often prudent to give these drugs to close family members as well.

Research charity Meningitis UK warns that the disease can kill in under four hours, which is why swift diagnosis and treatment are vital.

Steve Dayman, the chief executive of Meningitis UK who lost his own son to the disease in 1982, said: "This predictive model is an excellent step forward.

"We hear from families everyday who have lost relatives unbelievably quickly so anything which helps to identify and treat the disease quicker is a positive development.

"It's vital that the differentiation between bacterial and viral meningitis is made straightaway because the bacterial form can kill in less then four hours. Quick treatment can mean the difference between life and death.

"In the absence of a vaccine to protect against all forms of meningitis, this new model could help to save precious lives."

There are tests to identify the cause of meningitis, the best known being a lumbar puncture to obtain spinal fluid for analysis. However, this does not always yield clear-cut results.

The new model has a simple set of three criteria which helps doctors tell the difference without having to wait for conclusive spinal fluid results.

Researchers found them by examining 385 confirmed meningitis cases over a 12-month period.

The first two criteria are blood tests positive for two specific chemicals associated with bacterial meningitis, the third is the presence of the "classic" meningitis rash of spots which do not disappear when pressed with a glass.

The three results are combined to provide a score which then tells the doctor how likely bacterial meningitis is.

Dr Toyin Ejidokun, a consultant in communicable disease at the HPA, said: "The total score allows a treating clinician to simply and quickly assess the likelihood of whether or not the case is bacterial meningitis by checking it against the predictive probabilities we have developed.

"While further testing needs to take place to test the accuracy of the model, it offers the prospect of a rapid predictive tool to help clinical and public health management of suspected bacterial meningitis cases."