Differences Between Viral Meningitis and Abusive Head Trauma.

Creator(s)

Danielle Horton, Children's Mercy HospitalFollow
Tanya Burrell, Children's Mercy Kansas City
Mary Moffatt, Children's Mercy HospitalFollow
Henry T. Puls, Children's Mercy HospitalFollow
Rangaraj Selvarangan, Children's Mercy HospitalFollow
Lyndsey Hultman, Children's Mercy HospitalFollow
James Anderst, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

7-1-2022

Identifier

DOI: 10.1542/peds.2021-054544

Abstract

OBJECTIVES: To evaluate the hypothesis that viral meningitis may mimic abusive head trauma (AHT) by comparing the history of present illness (HPI) and clinical presentation of young children with proven viral meningitis to those with AHT and those with subdural hemorrhage (SDH) only. We hypothesized that significant differences would exist between viral meningitis and the comparison groups.

METHODS: We performed a 5-year retrospective case-control study of subjects agedyears, comparing those with confirmed viral meningitis (controls) to those with SDH evaluated by the hospital child abuse pediatrics team (cases). Cases were classified as SDH with concomitant suspicious injuries (AHT) and without concomitant suspicious injuries (SDH-only). Groups were compared across demographic (5 measures), HPI (11 measures), and clinical (9 measures) domains. Odds ratios were calculated for measures within each domain.

RESULTS: Of 550 subjects, there were 397 viral meningitis, 118 AHT, and 35 SDH-only subjects. Viral meningitis differed significantly from AHT subjects on all demographic measures, and from SDH-only subjects on age. Viral meningitis differed significantly from AHT subjects in all HPI measures with odds ratios ranging from 2.7 to 322.5, and from SDH-only subjects in 9 HPI measures with odds ratios ranging from 4.6 to 485.2. In the clinical domain, viral meningitis differed significantly from AHT subjects in all measures, with odds ratios ranging from 2.5 to 74.0, and from SDH-only subjects in 5 measures with odds ratios ranging from 2.9 to 16.8.

CONCLUSIONS: Viral meningitis is not supported as a mimic of AHT.

Journal Title

Pediatrics

Volume

150

Issue

1

MeSH Keywords

Case-Control Studies; Child; Child Abuse; Child, Preschool; Craniocerebral Trauma; Hematoma, Subdural; Humans; Infant; Meningitis, Viral; Retrospective Studies

Keywords

Case-Control Studies; Child Abuse; Craniocerebral Trauma; Subdural Hematoma; Viral Meningitis; Retrospective Studies

Recommended Citation

Horton D, Burrell T, Moffatt ME, et al. Differences Between Viral Meningitis and Abusive Head Trauma. Pediatrics. 2022;150(1):e2021054544. doi:10.1542/peds.2021-054544