ToolsCalculators
Bacterial Meningitis Score for Children
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.