Author Prof. J. Spranger, University Department of Pediatrics Mainz
In cases of “febrile seizures” any inflammatory conditions must be ruled out, especially all types of meningitis. Most children presenting with febrile seizures for the first time are admitted to a clinic for lumbar puncture, EEG, laboratory diagnostics and diagnostic imaging. In 2011, the American Academy of Pediatrics issued a guideline on when and under what circumstances these procedures can be forgone.
To examine the extent to which this guideline was followed and, if so, whether meningitis went untreated in many of these cases, the incident-related data of nearly 150,000 children who presented with their first febrile seizures between 2005 and 2019, as recorded in the United States Pediatric Health Insurance System (PHIS), was analysed .
First, it became apparent that the trend towards abandoning outpatient diagnostics, which had started in 2005, continued. Throughout the specified timeframe, five meningitis cases were overlooked, i.e. recognised and treated too late (misdiagnosis rate 0.0033%). This figure was contrasted with the reduction in medical costs brought about by outpatient treatment. They fell from $1,523 per patient in 2005 to $605 per patient in 2019.