How important is it to identify a child with bacteremia who does not need hospitalization due to a satisfactory condition? How will antibiotic treatment that started at the first visit of a doctor affect the final outcome of the disease?
We managed to find in modern literature 9 works in which the outcome of the disease in previously healthy and initially not hospitalized children with the development of asymptomatic bacteremia was studied.
(Seven patients described by Meyers are specifically excluded from the summary data due to the overly selective nature of this retrospective study. Of the 17 cases of pneumococcal bacteremia observed during one year, he selected only 7 cases. 3 of them developed meningitis. As will be noted below, this is an unusually high number.Another reason why Meyers materials were not included in the summary data was that 2 out of 7 children were previously sick: one child with meningitis received corticosteroids about a child’s spasm philia, another child was observed splenomegaly, caused by iron deficiency anemia and deficiency of glucose-6-phosphate dehydrogenase).
In these 9 studies presented materials about 357 children who were previously healthy and after the first examination were sent home from the emergency room or doctor’s office; however, later they had asymptomatic bacteremia.
The overall mortality rate was 0.3% (one child died of pneumococcal meningitis), the frequency of bacterial meningitis was 5%, the frequency of other dangerous or potentially dangerous bacterial infections was 4.8%.
So, although the mortality rate for asymptomatic bacteremia is quite low (3 per 1000), the risk of developing meningitis or other serious bacterial infections is not so small.