Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experience

PurposeThe widespread introduction of bacterial conjugate vaccines has decreased the risk of cerebrospinal fluid (CSF) pleocytosis due to bacterial meningitis (BM) in children. However, most patients with CSF pleocytosis are hospitalized and treated with parenteral antibiotics for several days. The...

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Main Authors: Jungpyo Lee, Hyeeun Kwon, Joon Soo Lee, Heung Dong Kim, Hoon-Chul Kang
Format: Article
Language:English
Published: Korean Pediatric Society 2015-07-01
Series:Korean Journal of Pediatrics
Subjects:
Online Access:http://kjp.or.kr/upload/pdf/kjped-58-251.pdf
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author Jungpyo Lee
Hyeeun Kwon
Joon Soo Lee
Heung Dong Kim
Hoon-Chul Kang
author_facet Jungpyo Lee
Hyeeun Kwon
Joon Soo Lee
Heung Dong Kim
Hoon-Chul Kang
author_sort Jungpyo Lee
collection DOAJ
description PurposeThe widespread introduction of bacterial conjugate vaccines has decreased the risk of cerebrospinal fluid (CSF) pleocytosis due to bacterial meningitis (BM) in children. However, most patients with CSF pleocytosis are hospitalized and treated with parenteral antibiotics for several days. The bacterial meningitis score (BMS) is a validated multivariate model derived from a pediatric population in the postconjugate vaccine era and has been evaluated in several studies. In the present study, we examined the usefulness of BMS in South Korean patients.MethodsThis study included 1,063 patients with CSF pleocytosis aged between 2 months and 18 years. The BMS was calculated for all patients, and the sensitivity and negative predictive value (NPV) of the test were evaluated.ResultsOf 1,063 patients, 1,059 (99.6%) had aseptic meningitis (AM). Only four patients (0.4%) had BM. The majority of patients (98%) had a BMS of ≤1, indicating a diagnosis of AM. The BMS was 0 in 635 patients (60%) and 1 in 405 patients (38%). All four BM patients had a BMS of ≥4.ConclusionTo our knowledge, this is the first study to investigate the diagnostic strength of the BMS in South Korea. In our study, the BMS showed 100% sensitivity and 100% NPV. Therefore, we believe that the BMS is a good clinical prediction rule to identify children with CSF pleocytosis who are at a risk of BM.
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spelling doaj.art-b6e96e4065d148a1abba70a00e62314e2022-12-21T18:39:15ZengKorean Pediatric SocietyKorean Journal of Pediatrics1738-10612092-72582015-07-0158725125510.3345/kjp.2015.58.7.25120125550482Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experienceJungpyo Lee0Hyeeun Kwon1Joon Soo Lee2Heung Dong Kim3Hoon-Chul Kang4Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.PurposeThe widespread introduction of bacterial conjugate vaccines has decreased the risk of cerebrospinal fluid (CSF) pleocytosis due to bacterial meningitis (BM) in children. However, most patients with CSF pleocytosis are hospitalized and treated with parenteral antibiotics for several days. The bacterial meningitis score (BMS) is a validated multivariate model derived from a pediatric population in the postconjugate vaccine era and has been evaluated in several studies. In the present study, we examined the usefulness of BMS in South Korean patients.MethodsThis study included 1,063 patients with CSF pleocytosis aged between 2 months and 18 years. The BMS was calculated for all patients, and the sensitivity and negative predictive value (NPV) of the test were evaluated.ResultsOf 1,063 patients, 1,059 (99.6%) had aseptic meningitis (AM). Only four patients (0.4%) had BM. The majority of patients (98%) had a BMS of ≤1, indicating a diagnosis of AM. The BMS was 0 in 635 patients (60%) and 1 in 405 patients (38%). All four BM patients had a BMS of ≥4.ConclusionTo our knowledge, this is the first study to investigate the diagnostic strength of the BMS in South Korea. In our study, the BMS showed 100% sensitivity and 100% NPV. Therefore, we believe that the BMS is a good clinical prediction rule to identify children with CSF pleocytosis who are at a risk of BM.http://kjp.or.kr/upload/pdf/kjped-58-251.pdfAseptic meningitisBacterial meningitisClinical prediction rule
spellingShingle Jungpyo Lee
Hyeeun Kwon
Joon Soo Lee
Heung Dong Kim
Hoon-Chul Kang
Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experience
Korean Journal of Pediatrics
Aseptic meningitis
Bacterial meningitis
Clinical prediction rule
title Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experience
title_full Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experience
title_fullStr Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experience
title_full_unstemmed Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experience
title_short Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experience
title_sort applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis a single center s experience
topic Aseptic meningitis
Bacterial meningitis
Clinical prediction rule
url http://kjp.or.kr/upload/pdf/kjped-58-251.pdf
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