Sensitivity of the Bacterial Meningitis Score in 889 Children with Bacterial Meningitis

• Published in: The Journal of pediatrics Vol. 152; no. 3; pp. 378 - 382
• Main Authors: Dubos, François, MD, De la Rocque, France, MD, Levy, Corinne, MD, Bingen, Edouard, MD, Aujard, Yannick, MD, Cohen, Robert, MD, Bréart, Gérard, MD, Gendrel, Dominique, MD, Chalumeau, Martin, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.03.2008; Elsevier
• Subjects: Adolescent; Bacteremia - diagnosis; Bacteremia - epidemiology; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Biological and medical sciences; Cerebrospinal Fluid - microbiology; Cerebrospinal Fluid Proteins - analysis; Child; Child, Preschool; Cohort Studies; Confidence Intervals; Female; General aspects; Gram-Negative Bacteria - isolation & purification; Gram-Positive Bacteria - isolation & purification; Human bacterial diseases; Humans; Infant; Infant, Newborn; Infectious diseases; Lymphocyte Count; Male; Medical sciences; Meningitis, Bacterial - cerebrospinal fluid; Meningitis, Bacterial - diagnosis; Meningitis, Bacterial - mortality; Pediatrics; Probability; Prognosis; Prospective Studies; Registries; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Survival Analysis; Validation Studies as Topic; PCT; Bacterial meningitis; Emergency department; Procalcitonin; CSF; BMS; BM; Bacterial meningitis score; Cerebrospinal fluid; ED; Human; Infection; Pediatrics; Nervous system diseases; Sensitivity; Score; Bacteriosis; Child
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2007.07.012

Objective To validate sensitivity of the bacterial meningitis score (BMS) in a large population of children with bacterial meningitis (BM). Study design Secondary analysis of prospective data for children presenting with BM to a hospital emergency department between January 2001 and February 2005. The BMS was applied to all children with acute BM using the same inclusion criteria proposed by the authors of the rule. The sensitivity of the rule was calculated. Results Of the 900 children aged 29 days to 18 years with acute BM who met all inclusion criteria, 889 had enough data for assigning the BMS. Use of the BMS correctly identified 884 children with BM, for 99.6% sensitivity (95% confidence interval: 98.9% to 99.8%). Conclusions The sensitivity of the BMS to detect disease was very high, but a few cases of BM were missed. Further refinements of the BMS may be warranted to lower the false-negative rate.