PMID: 9733248Sep 11, 1998Paper

Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant

Pediatric Emergency Care
C B PickertD H Fiser

Abstract

The differentiation of severe systemic infection, such as sepsis or meningitis, from a congenital obstructive left heart abnormality presents a unique challenge to clinicians responsible for the care of such infants in the first few weeks of life. Clinical findings are very similar in the two populations. Failure to identify the need for specific intervention, such as prostaglandin administration, by the primary care or emergency physician may result in increased morbidity or death in these infants. We undertook a retrospective review of critically ill infants 0 to 28 days of age presenting with either bacterial sepsis or meningitis or a congenital obstructive left heart syndrome (COLHS), in order to identify historical, physical, or laboratory findings which might differentiate the two groups at presentation. Discriminant analysis was performed using the presence or absence of COLHS as the dependent variable. A COLHS index was derived to determine its sensitivity and specificity for differentiating the two groups. The presence of cardiomegaly predicted COLHS with 85% sensitivity and 95% specificity. Cardiomegaly had a positive predictive value for COLHS of 0.95. Unfortunately, most of the other variables which, individually or...Continue Reading

Citations

Apr 26, 2001·Archives of Disease in Childhood. Fetal and Neonatal Edition·D J Penny, L S Shekerdemian
Mar 4, 2008·Early Human Development·Paul A Brooks, Daniel J Penny
Feb 6, 2013·Emergency Medicine Australasia : EMA·Claire L Barker
Jan 9, 2014·Journal of Paediatrics and Child Health·Neelam GuptaNeil Patel
Oct 12, 2004·Emergency Medicine Clinics of North America·James E CollettiDale P Woodridge
Jul 25, 2015·Advances in Pediatrics·Christie J Bruno, Thomas Havranek
Jan 29, 2020·Indian Journal of Pediatrics·Mani Ram Krishna, Raman Krishna Kumar
Aug 11, 2020·Journal of Paediatrics and Child Health·Stephanie M BoydKathryn Browning Carmo

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