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Table 1 Study clinical case definition

From: The aetiologies of central nervous system infections in hospitalised Cambodian children

Criteriona

Definition

Age

1 month – 15 years

Fever

≥38°C within 24 h of hospital admission

Clinical features

At least one of:

 • Stiff neck

 • Altered / reduced consciousness

  o V, P, or U on the AVPU score

  o <15 on the Glasgow Coma Score

 • Focal neurological symptoms / signs

 • Convulsions

  o Aged <6 months or ≥6 years: any seizure

  o Aged 6 months to <6 years: any focal or prolonged seizure OR ≥2 brief generalised seizures

 • Bulging fontanelle if <12 months of age

 • Irritability if <5 years of age

 • Headache

 • Prostration

  o Inability to drink or breast feed, or to remain sitting in a child otherwise able to sit

 • Petechial or purpuric rash

Laboratory investigation

Lumbar puncture performed, or actively planned at the time of assessment, by clinical team

  1. aFor study enrolment, all four criteria had to be met (age, fever, clinical, and laboratory)