{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T10:36:03Z","timestamp":1786703763140,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Adelaide University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study of IMD cases aged 15\u201325 years admitted between 2005 and 2018 in ten Australian hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u00a0day 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Delayed presentation was associated with a higher risk of IMD complications, highlighting the importance of early assessment and timely management to improve outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      Clinicaltrails.gov, NCT03798574,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT03798574\" ext-link-type=\"uri\">https:\/\/clinicaltrials.gov\/study\/NCT03798574<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02827-6","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T09:22:23Z","timestamp":1779096143000},"page":"1991-2000","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed diagnosis is associated with complications following invasive meningococcal disease in Australian adolescents and young adults"],"prefix":"10.1007","volume":"54","author":[{"given":"Mark","family":"McMillan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassen","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Buttery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Angliss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Barton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C.","family":"Blyth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suja M.","family":"Mathew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgyn S.","family":"Warner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renjy","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory","family":"Hannah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Runnegar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2521-5166","authenticated-orcid":false,"given":"Helen Siobhan","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"issue":"5","key":"2827_CR1","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/S1473-3099(10)70048-7","volume":"10","author":"K Edmond","year":"2010","unstructured":"Edmond K, Clark A, Korczak VS, Sanderson C, Griffiths UK, Rudan I. 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HSM\u2019s, MM\u2019s, HM, and SM\u2019s respective institutions receive funding for investigator-led studies (including Pfizer and Sanofi-Pasteur). HSM, MM, HM, and SM receive no personal payments from Industry. RN is an investigator on trials sponsored by Industry (Astra Zeneca, Medpace Armata Pharmaceuticals, Gilead, GSK). RN does not receive any personal payments from Industry. JB\u2019s institution received funding for his roles as a DSMB member for clinical trials (including the GSK group of companies).","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Pfizer reviewed the study protocol, but the funder had no role in the study design, data collection, or analysis and had no involvement in the development of this publication.","order":2,"name":"Ethics","label":"Role of funder\/sponsor","group":{"name":"EthicsHeading","label":"Declarations"}}]}}