Meningitis, which is characterized usually by light sensitivity, stiff neck, headache and mottled skin, has other symptoms like leg ache, coldness of hands and feet and abnormal skin color that can help diagnose it hours earlier, a study by UK's Oxford University researchers has found.
Usually, the classically accepted symptoms occur between 13 and 22 hours after infection when the disease has progressed increasing the chances of the patient's death. The newly discovered symptoms occur about seven hours after the illness, making it easier to save the lives of those who have contracted it, the study on children showed.
“Most children had only non-specific symptoms in the first four to six hours but were close to death by 24 hours. Since infection can progress from initial symptoms to death within hours, individuals must be diagnosed as early as possible,” said Dr Matthew Thompson, lead author of the study.
Under the study, researchers studied around 448 child patients of meningitis over a period 15 months. Around 72 per cent of these children exhibited the new symptoms, with 63 per cent reporting leg ache, 47 per cent developing cold feet and hands and 21 per cent showing a weird skin color.
About 103 children succumbed to the disease and the classic symptoms were demonstrated in a majority of children only after a long time had elapsed after infection. Only about 165 children of the 448 were checked into a hospital immediately after they visited a physician, with 49 per cent being sent back home with an incorrect diagnosis.
“Although we must avoid undermining the importance of classic symptoms, we could substantially speed up diagnosis if the emphasis was shifted to early recognition of sepsis. This . . . does not mean that all parents of children with (the new symptoms) should be warned that their child may have meningococcal disease. But it does mean that such a disease can rarely be excluded by clinical examination in the first four to six hours,” Dr Thompson said.
He added that most of the times, parents and doctors are misguided by the absence of the classic symptoms. “We believe that primary-care clinicians are over-reliant on using these three symptoms to diagnose meningococcal disease in children. Moreover, clinicians and parents may be falsely reassured by the absence of these features,” Dr Thompson said.
An inflammation of the membranes surrounding and brain and the spinal cord, meningitis causes brain damage and subsequently death. Infection can be through bacterial, viral, fungal or parasitic modes and as the disease progresses, the patients becomes disoriented and starts losing mental functions.
According to Robert Booy of the National Center for Immunization Research and Surveillance, visiting a doctor as soon as the newly discovered symptoms are noticed might help save the child's life. “Certainly cold hands and feet is as important as leg pain as well as abdominal pain . . . so I think they have shown something we thought,” he said.
Added Cristiana Nascimento-Carvalho and Otavio Moreno-Carvalho from the Federal University of Bahia in Brazil in an editorial accompanying the study report in
The Lancet, “Delay in providing appropriate treatment is common in children who die of meningococcal disease. To wait for the late signs of meningitis is a glaring mistake if meningococcal disease is to be promptly diagnosed.”
