Koomen et al developed a nomogram for predicting the risk of hearing loss in a school aged child with bacterial meningitis. This can help identify patients who should undergo careful screening upon recovery. The authors are from VU Medical Center Amsterdam and University Medical Center Utrecht in the Netherlands.
Parameters (with values extracted from the nomogram in Figure 1, page 1052):
(1) duration of symptoms
(2) petechiae
(3) CSF glucose
(4) presence of Streptococcus pneumoniae
(5) ataxia
|
Parameter |
Finding |
Points |
|
duration of symptoms |
<= 2 days |
0 |
|
|
> 2 days |
10.1 |
|
petechiae |
absent |
27.4 |
|
|
present |
0 |
|
CSF glucose |
<= 0.6 mmol/L |
15 |
|
|
> 0.6 mmol/L (10.8 mg/dL) |
0 |
|
Streptococcus pneumoniae |
absent |
0 |
|
|
present |
12.4 |
|
ataxia |
absent |
0 |
|
|
present |
36.1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 101
• The higher the score the higher the risk of deafness.
|
Points |
Percent with Hearing Loss |
|
< 3.5 |
< 1% |
|
3.5 to 60.4 |
(0.000168 * ((points)^3)) - (0.004536 * ((points)^2)) + (0.151 * (points)) + 0.5210 |
|
60.4 to 79.6 |
(1.565 * (points)) - 64.65 |
|
79.6 to 118.9 |
(-0.01731 * ((points)^2)) + (4.323 * (points)) - 174.4 |
|
> 118.9 |
> 95% |
Specialty: Infectious Diseases, Neurology
