Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experience

The widespread introduction of bacterial conjugate vaccines has decreased the risk of cerebrospinal fluid (CSF) pleocytosis due to bacterial meningitis (BM) in children. However, most patients with CSF pleocytosis are hospitalized and treated with parenteral antibiotics for several days. The bacteri...

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Bibliographic Details
Published in:Clinical and experimental pediatrics 2015, 58(7), , pp.251-255
Main Authors: Lee, Jungpyo, Kwon, Hyeeun, Lee, Joon Soo, Kim, Heung Dong, Kang, Hoon-Chul
Format: Article
Language:English
Subjects:
Antibiotics
Aseptic meningitis
Bacterial infections
Bacterial meningitis
Blood
Clinical prediction rule
Encephalitis
Illnesses
Immunization
Laboratories
Meningitis
Mortality
Neurosurgery
Nosocomial infections
Original
Patients
Pediatrics
Streptococcus infections
Vaccines
소아과학
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Summary:The widespread introduction of bacterial conjugate vaccines has decreased the risk of cerebrospinal fluid (CSF) pleocytosis due to bacterial meningitis (BM) in children. However, most patients with CSF pleocytosis are hospitalized and treated with parenteral antibiotics for several days. The bacterial meningitis score (BMS) is a validated multivariate model derived from a pediatric population in the postconjugate vaccine era and has been evaluated in several studies. In the present study, we examined the usefulness of BMS in South Korean patients. This study included 1,063 patients with CSF pleocytosis aged between 2 months and 18 years. The BMS was calculated for all patients, and the sensitivity and negative predictive value (NPV) of the test were evaluated. Of 1,063 patients, 1,059 (99.6%) had aseptic meningitis (AM). Only four patients (0.4%) had BM. The majority of patients (98%) had a BMS of ≤1, indicating a diagnosis of AM. The BMS was 0 in 635 patients (60%) and 1 in 405 patients (38%). All four BM patients had a BMS of ≥4. To our knowledge, this is the first study to investigate the diagnostic strength of the BMS in South Korea. In our study, the BMS showed 100% sensitivity and 100% NPV. Therefore, we believe that the BMS is a good clinical prediction rule to identify children with CSF pleocytosis who are at a risk of BM.
ISSN:1738-1061
2092-7258
2713-4148
DOI:10.3345/kjp.2015.58.7.251