Publications

Meningitis is a potentially life-threatening condition characterized by infection orinflammation of the central nervous system. It is classified as bacterial, viral, or aseptic.Delayed or untreated bacterial meningitis is associated with high morbidity and mortality. Itis important to accurately distinguish between bacterial and nonbacterial meningitis. Mostphysicians will perform a lumbar puncture and consider antibiotics for all infants andchildren with suspected meningitis. Having a clinical prediction rule to determine the needfor lumbar puncture and which patients need antibiotics could reduce morbidity and the costassociated with unnecessary procedures and treatment. Several clinical prediction rules todetermine the risk of bacterial meningitis have been proposed. One clinical prediction rule,derived and validated from cohorts seen in pediatric hospitals in the Netherlands, found thataltered consciousness, meningeal irritation, cyanosis, petechiae, vomiting, duration of mainsymptom, and an elevated C-reactive protein and Erythrocyte Sedimentation Rate level wereindependent predictors of bacterial meningitis. Patients below a predefined threshold on arisk score incorporating these elements could be safely considered as not having bacterialmeningitis