Diagnostic characteristics of symptoms for meningococcal disease, comparing children with minor febrile infection (n = 407) versus case-fatality rate-adjusted meningococcal disease (n = 345).
| Symptom | Sensitivity, % (95% CI) | Specificity, % (95% CI) | Positive likelihood ratio (95% CI) | Negative likelihood ratio (95% CI) |
|---|---|---|---|---|
| Classic meningeal features | ||||
| Photophobia | 25.5 (20.2 to 30.8) | 96.1 (94.2 to 98.0) | 6.5 (3.8 to 11.0) | 0.7 (0.7 to 0.8) |
| Neck pain or stiffness | 30.3 (24.8 to 35.9) | 94.3 (92.1 to 96.6) | 5.3 (3.5 to 8.3) | 0.7 (0.7 to 0.8) |
| Headache | 35.1 (28.3 to 41.9) | 64.5 (59.6 to 69.4) | 1.0 (0.8 to 1.3) | 1.0 (0.9 to 1.1) |
| Suggested ‘red flag’ features | ||||
| Leg pain | 43.8 (36.7 to 50.8) | 94.3 (91.9 to 96.6) | 7.6 (4.9 to 11.9) | 0.6 (0.5 to 0.7) |
| Cold hands or feet | 43.1 (37.1 to 49.1) | 81.8 (78.1 to 85.6) | 2.3 (1.9 to 3.0) | 0.7 (0.6 to 0.8) |
| Pale colour | 14.0 (9.8 to 18.3) | 58.5 (53.7 to 63.3) | 0.3 (0.2 to 0.5) | 1.5 (1.3 to 1.6) |
| Other features | ||||
| Confusion | 46.4 (39.3 to 53.5) | 98.1 (96.7 to 99.5) | 24.2 (11.5 to 51.3) | 0.5 (0.5 to 0.6) |
| Drowsy or very sleepy | 85.5 (81.3 to 89.8) | 65.1 (60.5 to 69.7) | 2.5 (2.1 to 2.8) | 0.2 (0.2 to 0.3) |
| Rash or new spots on skin | 77.6 (72.5 to 82.7) | 86.0 (82.6 to 89.4) | 5.5 (4.3 to 7.1) | 0.3 (0.2 to 0.3) |
| Nausea or vomiting | 72.7 (67.3 to 78.1) | 63.9 (59.2 to 68.5) | 2.0 (1.7 to 2.3) | 0.4 (0.3 to 0.5) |
| Irritable or miserable | 72.6 (67.1 to 78.0) | 47.7 (42.8 to 52.5) | 1.4 (1.2 to 1.6) | 0.6 (0.5 to 0.7) |
| General aching | 41.2 (35.3 to 47.2) | 76.9 (72.8 to 81.0) | 1.8 (1.4 to 2.2) | 0.8 (0.7 to 0.9) |
| Difficult/laboured breathing | 10.5 (6.8 to 14.3) | 86.7 (83.4 to 90.0) | 0.8 (0.5 to 1.2) | 1.0 (1.0 to 1.1) |