Evidence map›Paper›PMID 42149359›Full record

ArticleInfection2026

Delayed diagnosis is associated with complications following invasive meningococcal disease in Australian adolescents and young adults.

Mark McMillan, Hassen Mohammed, Jim Buttery, Margaret Angliss, Belinda Barton, Christopher C Blyth, Suja M Mathew, Morgyn S Warner, Renjy Nelson, Rory Hannah and 2 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03798574 (The Long-term Impact of Invasive Meningococcal Disease in Australian Adolescents and Young Adults), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03798574 completednot on this map

The Long-term Impact of Invasive Meningococcal Disease in Australian Adolescents and Young Adults

TypeobservationalSponsorUniversity of AdelaideRan2016 to 2022Enrolled98ConditionsMeningococcal Infections, Neisseria Meningitis Sepsis, Neisseria Infection
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Mark McMillan *Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, North Adelaide, Adelaide, SA, 5006, Australia.
Hassen Mohammed *Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, North Adelaide, Adelaide, SA, 5006, Australia.
Jim ButteryDepartment of Infection and Immunity, Monash Children's Hospital, Melbourne, VIC, Australia.
Margaret AnglissDepartment of Infection and Immunity, Monash Children's Hospital, Melbourne, VIC, Australia.
Belinda BartonFaculty of Health, CHERI, The Children's Hospital at Westmead, Southern Cross University, Lismore, NSW, Australia.
Christopher C BlythWesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Suja M MathewVaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, North Adelaide, Adelaide, SA, 5006, Australia.
Morgyn S WarnerInfectious Disease Unit, Central Adelaide Local Health Network, Adelaide, SA, Australia.
Renjy NelsonInfectious Disease Unit, Central Adelaide Local Health Network, Adelaide, SA, Australia.
Rory HannahInfectious Diseases, Clinical Immunology and Allergy Division of Medicine Lyell McEwin Hospital, Adelaide, SA, Australia.
Naomi RunnegarInfection Management Services, Princess Alexandra Hospital and University of Queensland, Brisbane, Australia.
Helen Siobhan MarshallVaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, North Adelaide, Adelaide, SA, 5006, Australia. helen.marshall@adelaide.edu.au.ORCID http://orcid.org/0000-0003-2521-5166

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study described the presenting features, initial assessment, hospital care, and complications at discharge among Australian adolescents and young adults with Invasive meningococcal disease (IMD).

methodsWe conducted a retrospective study of IMD cases aged 15-25 years admitted between 2005 and 2018 in ten Australian hospitals.

resultsA 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.

conclusionDelayed presentation was associated with a higher risk of IMD complications, highlighting the importance of early assessment and timely management to improve outcomes. CLINICAL

trial registrationClinicaltrails.gov, NCT03798574, https://clinicaltrials.gov/study/NCT03798574 .

Indexed as

Delayed DiagnosisMeningococcal InfectionsAdolescentAdultAustraliaFemaleHumansMaleRetrospective StudiesYoung AdultAdolescents and young adultsInvasive meningococcal diseaseMeningococcal diseaseSequelae

Identifiers

PMID42149359
PMCPMC13476282

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.