Neurology Book

Infectious Disease

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Oostenbrink Clinical Decision Rule for Meningitis

Aka: Oostenbrink Clinical Decision Rule for Meningitis, Dutch Meningitis Prediction Rule
  1. See Also
    1. Nigrovic Clinical Decision Rule (for CSF evaluation)
  2. Indications
    1. Meningitis evaluation in children
    2. Evaluate need for Lumbar Puncture in children ages 1 month to 15 years old
  3. Criteria: Sum the Positive Scores
    1. Symptoms
      1. Score 1/day: Main symptom duration (maximum of 10 days)
      2. Score 2: Vomiting
    2. Signs
      1. Score 8: Altered Level of Consciousness
      2. Score 7.5: Meningeal Irritation
      3. Score 6.5: Cyanosis
      4. Score 4: Petechiae
    3. C-Reactive Protein (CRP)
      1. Score 0: CRP <5 mg/dl or <50 mg/L
      2. Score 0.5: CRP 5 to 9.9 mg/dl or 50 to 99 mg/L
      3. Score 1: CRP 10 to 14.9 mg/dl or 100 to 149 mg/L
      4. Score 1.5: CRP 15 to 19.9 mg/dl or 150 to 199 mg/L
      5. Score 2: CRP >20 mg/dl or >200 mg/L
  4. Interpretation
    1. Score >8.5 points indicates need for Lumbar Puncture due to Bacterial Meningitis risk
  5. References
    1. Oostenbrink (2001) Acta Paediatr 90:611-7 [PubMed]
    2. Oostenbrink (2004) Eur J Epidemiol 19(2):115 [PubMed]

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