Can the Pediatric Bacterial Meningitis Score Be Applied to Adults?

In a retrospective study, the score was 100% sensitive for bacterial meningitis.

Patients with cerebrospinal fluid (CSF) pleocytosis are often admitted to the hospital but later receive a diagnosis of aseptic meningitis. Avoiding these unneeded hospitalizations would be beneficial.

The Bacterial Meningitis Score designates a patient as low risk (and therefore eligible for outpatient management) if none of five predictors are present: positive CSF Gram stain, CSF absolute neutrophil count (ANC) ≥1000 cells/mm³, CSF protein ≥80 mg/dL, peripheral blood ANC ≥10,000 cells/mm³, or history of seizure at or before presentation. The score was validated in children and found to have a negative predictive value of 99.9% (NEJM JW Pediatr Adolesc Med Mar 2007 and JAMA 2007; 297:52). Now, investigators applied the score retrospectivel…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Can the Pediatric Bacterial Meningitis Score Be Applied to Adults?

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Reviewing Author