![]() ![]() Results Among 3295 patients with CSF pleocytosis, 121 (3.7% 95% confidence interval, 3.1%-4.4%) had bacterial meningitis and 3174 (96.3% 95% CI, 95.5%-96.9%) had aseptic meningitis. Main Outcome Measure The sensitivity and negative predictive value of the Bacterial Meningitis Score. All children aged 29 days to 19 years who presented at participating emergency departments between January 1, 2001, and June 30, 2004, with CSF pleocytosis (CSF white blood cells ≥10 cells/μL) and who had not received antibiotic treatment before lumbar puncture. Objective To validate the Bacterial Meningitis Score in the era of widespread pneumococcal conjugate vaccination.ĭesign, Setting, and Patients A multicenter, retrospective cohort study conducted in emergency departments of 20 US academic medical centers through the Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. We previously developed a clinical prediction rule, the Bacterial Meningitis Score, that classifies patients at very low risk of bacterial meningitis if they lack all of the following criteria: positive CSF Gram stain, CSF absolute neutrophil count (ANC) of at least 1000 cells/μL, CSF protein of at least 80 mg/dL, peripheral blood ANC of at least 10 000 cells/μL, and a history of seizure before or at the time of presentation. ![]() ![]() ![]() duPont Hospital for Children and Thomas Jefferson Medical College, Wilmington, Del (Dr Bennett) Department of Pediatrics, Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, Ill (Dr Katsogridakis) Department of Emergency Medicine, Children's Medical Center and Medical College of Georgia, Augusta (Dr Mohseni) Department of Emergency Medicine, Phoenix Children's Hospital and University of Arizona College of Medicine, Phoenix (Dr Bulloch) Departments of Emergency Medicine and Pediatrics, Hasbro Children's Hospital and Brown Medical School, Providence, RI (Dr Steele) Department of Emergency Medicine, Children's Hospital and Regional Medical Center, and University of Washington School of Medicine, Seattle (Dr Kaplan) Department of Pediatrics, Le Bonheur Children's Medical Center and University of Tennessee Health Science Center, College of Medicine, Memphis (Dr Herman) Department of Emergency Medicine, Children's Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee, and Pediatric Emergency Medicine Associates LLC, Children's Healthcare of Atlanta at Scottish Rite, Atlanta, Ga (Dr Bandyopadhyay) Department of Emergency Medicine, Morgan Stanley Children's Hospital of New York-Presbyterian and Columbia University College of Physicians and Surgeons, New York, NY (Dr Dayan) Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles (Dr Wang) and Department of Emergency Medicine, Columbus Children's Hospital and The Ohio State University, Columbus (Drs Bonsu and Chapman).Ĭontext Children with cerebrospinal fluid (CSF) pleocytosis are routinely admitted to the hospital and treated with parenteral antibiotics, although few have bacterial meningitis. Shared Decision Making and CommunicationĪuthor Affiliations: Department of Medicine, Children's Hospital Boston and Harvard Medical School, Boston, Mass (Drs Nigrovic and Malley) Departments of Emergency Medicine (Dr Kuppermann) and Pediatrics (Drs Kuppermann and Truong), University of California, Davis Medical Center, Sacramento, and University of California, Davis School of Medicine, Davis Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston (Dr Macias) Department of Emergency Medicine, Rady Children's Hospital San Diego Medical Center (Dr Kanegaye) and Department of Pediatrics, University of California, San Diego School of Medicine, San Diego (Drs Cannavino and Kanegaye) Wake Emergency Physicians, PA and WakeMed Health and Hospitals, Raleigh, NC (Dr Moro-Sutherland) Department of Pediatrics, Children's Mercy Hospitals and Clinics and University of Missouri-Kansas City School of Medicine, Kansas City (Dr Schremmer) Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia (Dr Schwab) Department of Emergency Medicine, Children's National Medical Center and George Washington University School of Medicine, Washington, DC (Dr Agrawal) Department of Emergency Medicine, Children's Hospital and Research Center Oakland, Oakland, Calif (Dr Mansour) Department of Pediatrics, Alfred I.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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