ToolsCalculators
Bacterial Meningitis Score for Children
Distinguishes bacterial from aseptic meningitis in children with CSF pleocytosis.
Bacterial Meningitis Score for Children
CSF Gram stain positive for organisms
CSF absolute neutrophil count ≥1000 cells/µL
CSF protein ≥80 mg/dL
Peripheral blood absolute neutrophil count ≥10,000 cells/µL
Seizure at or before presentation
Result0 points
Very low risk of bacterial meningitis; a score of 0 carried a negative predictive value of nearly 100% in the derivation and validation cohorts.
- Score
- 0 of 6
- Risk category
- Very low risk
When to use
- Children with CSF pleocytosis in whom bacterial versus aseptic (viral) meningitis is being distinguished, to support safe outpatient management of very-low-risk children.
- Not intended for infants who are critically ill, pretreated with antibiotics before lumbar puncture, or immunocompromised.
Formula
Points: CSF Gram stain positive = 2; CSF ANC ≥1000 cells/µL = 1; CSF protein ≥80 mg/dL = 1; peripheral blood ANC ≥10,000 cells/µL = 1; seizure at or before presentation = 1. Total range 0-6.
Pearls and pitfalls
- A score of 0 was associated with a negative predictive value of ~100% for bacterial meningitis in the original derivation and in subsequent validation studies.
- Should not be applied to neonates ≤28 days of age, or to children with a ventricular shunt, recent neurosurgery, or immunosuppression.