Meningitis or Encephalitis

a. Meningitis or Encephalitis Suspected or Proven?

Select “Yes” if the infant was suspected or proven to have bacterial, fungal or viral meningitis or encephalitis at any time prior to discharge from your hospital, as recorded in the infant medical record.  Suspected meningitis or encephalitis includes cases in which no organism was recovered from the CSF or brain biopsy but clinical findings, serology, and/or CSF findings suggest meningitis or encephalitis.  

Select “No” if the infant was not suspected or proven to have bacterial, fungal or viral meningitis or encephalitis at any time prior to discharge from your hospital, as recorded in the infant medical record.

Select “Unknown” if the infant medical record was missing and unavailable for review.

Note: If meningitis or encephalitis was suspected or proven, answer questions b. through d. below.  Do not answer these questions if meningitis or encephalitis was not suspected or proven.

b. Bacterial Meningitis or Encephalitis

Select “None” if the infant did not have suspected or proven bacterial meningitis or encephalitis at any time prior to discharge from your hospital, as recorded in the infant medical record.

Select “Suspected” if the infant had suspected bacterial meningitis or encephalitis recorded in the infant medical record at any time prior to discharge from your hospital.  Suspected bacterial meningitis or encephalitis includes cases in which no organism was recovered from the CSF or brain biopsy but clinical findings, serology, and/or CSF findings suggest bacterial meningitis or encephalitis.  

Select “Proven” if the infant had bacterial meningitis or encephalitis documented in the medical record at any time prior to discharge from your hospital, with a positive culture of the CSF or brain biopsy specimen.

Note: If bacterial meningitis or encephalitis was suspected, only answer question (1) below.  If bacterial meningitis or encephalitis was proven, answer both questions (1) and (2) below.  Do not answer these questions if bacterial meningitis or encephalitis was not suspected or proven.

(1) Onset of Bacterial Meningitis or Encephalitis:

Note: Answer based on the first episode if there are multiple episodes. The date of birth is Day 1 regardless of the time of birth.  For example, if an infant is born at 11:59 PM on September 1, 2006, Day 3 will be September 3, 2006.  Any infection occurring on September 1, 2 or 3 would be counted as “Early”, and any infection after September 3 as “Late”.

Select“Early” if the onset of bacterial meningitis or encephalitis was within 3 days of birth.

Select “Late” if the onset of bacterial meningitis or encephalitis was more than 3 days after birth.

Select “Unknown” if the onset of bacterial meningitis or encephalitis was unknown.

(2) Name of Bacterial Meningitis or Encephalitis Organism:

If a proven bacterial meningitis or encephalitis organism was recovered, record the name of the organism in the space provided.

c. Fungal Meningitis or Encephalitis

Select“None” if the infant did not have suspected or proven fungal meningitis or encephalitis at any time prior to discharge from your hospital, as recorded in the infant medical record.

Select“Suspected” if the infant had suspected fungal meningitis or encephalitis recorded in the infant medical record at any time prior to discharge from your hospital.  Suspected fungal meningitis or encephalitis includes cases in which no organism was recovered from the CSF or brain biopsy but clinical findings, serology, and/or CSF findings suggest fungal meningitis or encephalitis.  

Select“Proven” if the infant had fungal meningitis or encephalitis documented in the medical record at any time prior to discharge from your hospital, with a positive culture of the CSF or brain biopsy specimen.

Note: If fungal meningitis or encephalitis was suspected, only answer question (1) below.  If fungal meningitis or encephalitis was proven, answer both questions (1) and (2) below.  Do not answer these questions if fungal meningitis or encephalitis was not suspected or proven.

(1) Onset of Fungal Meningitis or Encephalitis:

Note: Answer based on the first episode if there are multiple episodes. The date of birth is Day 1 regardless of the time of birth.  For example, if an infant is born at 11:59 PM on September 1, 2006, Day 3 will be September 3, 2006.  Any infection occurring on September1, 2 or 3 would be counted as “Early”, and any infection after September 3 as “Late”.

Select“Early” if the onset of fungal meningitis or encephalitis was within 3 days of birth.

Select “Late” if the onset of fungal meningitis or encephalitis was more than 3 days after birth.

Select “Unknown” if the onset of fungal meningitis or encephalitis was unknown.

(2) Name of Fungal Meningitis or Encephalitis Organism:

If a proven fungal meningitis or encephalitis organism was recovered, record the name of the organism in the space provided.

d. Viral Meningitis or Encephalitis

Select “None” if the infant did not have suspected or proven viral meningitis or encephalitis at any time prior to discharge from your hospital, as recorded in the infant medical record.

Select “Suspected” if the infant had suspected viral meningitis or encephalitis recorded in the infant medical record at any time prior to discharge from your hospital.  Suspected viral meningitis or encephalitis includes cases in which no organism was recovered from the CSF or brain biopsy but clinical findings, serology, and/or CSF findings suggest viral meningitis or encephalitis.  

Select “Proven” if the infant had viral meningitis or encephalitis documented in the medical record at any time prior to discharge from your hospital, with a positive culture of the CSF or brain biopsy specimen.  

(1) Onset of Viral Meningitis or Encephalitis:

Note: Answer based on the first episode if there are multiple episodes. The date of birth is Day 1 regardless of the time of birth.  For example, if an infant is born at 11:59 PM on September 1, 2006, Day 3 will be September 3, 2006.  Any infection occurring on September1, 2 or 3 would be counted as “Early”, and any infection after September 3 as “Late”.

Select “Early” if the onset of viral meningitis or encephalitis was within 3 days of birth.

Select “Late” if the onset of viral meningitis or encephalitis was more than 3 days after birth.

Select “Unknown” if the onset of viral meningitis or encephalitis was unknown.

(2) Name of Viral Meningitis or Encephalitis Organism:

If a proven viral meningitis or encephalitis organism was recovered, record the name of the organism in the space provided.