Prognostic Score of Stiehm and Damrosch in Meningococcal Infection

 

Unfavorable prognostic features in meningococcal infections:

(1) presence of petechiae < 12 hours prior to admission

(2) presence of shock (systolic blood pressure <= 70 mm Hg)

(3) absence of meningitis (CSF WBC count < 20 per µL)

(4) blood leukocyte count normal or low (<= 10,000 per µL)

(5) erythrocyte sedimentation rate (ESR) normal or low (< 10 mm per hour)

 

prognostic score =

= (number of unfavorable prognostic features present)

 

Prognostic Score	Mortality Rate
0	4.7%
1	7.7%
2	0%
3	85.7%
4	100%
5	100%

 

Comments:

• The absence of ESR data has limited the use of the score in retrospective studies.

• Tesoro suggests that the score of Stiehm and Damrosch may no longer be reliable. A low score indicates good prognosis, but a high score may not be predictive of a poor outcome.