Journal article
Delayed diagnosis is associated with complications following invasive meningococcal disease in Australian adolescents and young adults
Infection, Vol.First online, pp.1-10
18/05/2026
PMID: 42149359
Appears in Recent Faculty of Health Publications
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Abstract
Purpose: This study described the presenting features, initial assessment, hospital care, and complications at discharge among Australian adolescents and young adults with Invasive meningococcal disease (IMD).
Methods: We conducted a retrospective study of IMD cases aged 15-25 years admitted between 2005 and 2018 in ten Australian hospitals.
Results: A total of 104 IMD cases were included; 95.2% were due to serogroup B, and the mean age was 19.3 years (SD 2.1). Initial assessment most commonly occurred in the emergency department following self-presentation/private transport (50.0%), followed by general practice (32.4%) and paramedic-led pre-hospital care (17.7%). The most common nonspecific presenting symptoms were headache (80.8%), vomiting or nausea (75.0%), and fever (72.1%), and category 3 was the most frequently assigned triage level (40.6%). Half of cases required ICU admission (50.0%), with a mean ICU stay of 2.8 days (SD 2.4). Compared with patients who self-presented to the emergency department, initial assessment by paramedics in the community was associated with higher odds of ICU admission (adjusted AOR 4.42, 95% CI 1.81 to 16.5). A delay of more than 1 day between symptom onset and first medical presentation was associated with higher odds of discharge with one or more complications (aOR 2.88, 95% CI 1.13 to 7.35). At discharge, 43.3% had at least one complication, most commonly neurological sequelae (55.6% of those with complications), and 2 cases (1.9%) died.
Conclusion: Delayed presentation was associated with a higher risk of IMD complications, highlighting the importance of early assessment and timely management to improve outcomes.
Clinical trrial registration: Clinicaltrails.gov, NCT03798574, https://clinicaltrials.gov/study/NCT03798574 .
Details
- Title
- Delayed diagnosis is associated with complications following invasive meningococcal disease in Australian adolescents and young adults
- Creators
- Mark McMillan - Women's and Children's Health NetworkHassen Mohammed - Women's and Children's Health NetworkJim Buttery - Monash Children’s HospitalMargaret Angliss - Monash Children’s HospitalBelinda Barton - Southern Cross UniversityChristopher C Blyth - The Kids Research Institute AustraliaSuja M Mathew - Women's and Children's Health NetworkMorgyn S Warner - Central Adelaide Local Health NetworkRenjy Nelson - Central Adelaide Local Health NetworkRory Hannah - Lyell McEwin HospitalNaomi Runnegar - Princess Alexandra HospitalHelen Siobhan Marshall - Women's and Children's Health Network
- Publication Details
- Infection, Vol.First online, pp.1-10
- Publisher
- Springer Nature
- Grant note
- Open Access funding enabled and organized by CAUL and its Member Institutions. The study was an investigator-led trial, funded by Pfizer.
- Identifiers
- 991013376467802368
- Copyright
- © The Author(s) 2026.
- Academic Unit
- Human Sciences; Faculty of Health
- Language
- English
- Resource Type
- Journal article