Neurology Book



Aka: Meningitest
  1. See Also
    1. Nigrovic Clinical Decision Rule
    2. Oostenbrink Clinical Decision Rule for Meningitis
  2. Indications
    1. Bacterial Meningitis evaluation in children
  3. Contraindications: Exclusion Criteria
    1. Neurosurgical history
    2. Immunosuppression
    3. CSF RBC Count >0.1 x10^6/ul
    4. Antibiotic use in last 48 hours
  4. Criteria (1 point for each)
    1. CSF Gram Stain Positive for organisms
    2. CSF Protein >50 mg/dl
    3. Seizure related to current episode
    4. Purpura
    5. Irritability
    6. Serum Procalcitonin >= 0.5ng/ml
    7. Peripheral Absolute Neutrophil Count > 10,000 cells/mm3
    8. CSF Absolute Neutrophil Count >1000 cells/mm3
  5. Efficacy
    1. Test Sensitivity: 100% (96-100%)
  6. Interpretation
    1. Positive if presence of any of above (1 or more points)
    2. Suggests higher likelihood of Bacterial Meningitis
  7. References
    1. Dubos (2009) Curr Opin Neurol 22(3): 288-93 [PubMed]

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