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Following the introduction of vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae in the U.S., the incidence of bacterial meningitis in children has declined dramatically. In a multisite, retrospective cohort study, investigators validated a previously developed prediction rule, the Bacterial Meningitis Score.
Subjects were children between the ages of 29 days and 19 years with cerebrospinal fluid (CSF) pleocytosis (i.e., white-blood-cell count ≥10 cells/μL) who were not critically ill and had not received antibiotics in the previous 72 hours. They were considered at risk for bacterial meningitis if they met any of the following five criteria: positive CSF Gram stain; CSF absolute neutrophil count ≥1000 cells/μL; CSF …