RESUMEN
BACKGROUND@#The majority of adult patients with meningitis are admitted and receive empiric antimicrobial therapy pending the results of CSF cultures, which are expensive and time-consuming, leaving patients at risk for delayed management. The diagnostic and management challenge of tuberculous meningitis (TBM) fostered the development of the Thwaites’ Diagnostic Scoring. @*OBJECTIVE@#This study aims to validate the utility of Thwaites scoring system in identifying and differentiating tuberculous from bacterial meningitis (BM) in patients with suspected central nervous system infection. @*METHODS@#Fifty patients who were admitted at the Neurology Ward of Jose R. Reyes Memorial Medical Center (JRRMMC) from June 2017 to June 2020 were included in this retrospective crosssectional study.@*RESULTS@#There was no significant association between TBM and the following demographic and clinical variables: age, gender, BMI, co-morbidities, imaging studies; however, CSF PMN was significantly higher among BM cohort compared to TBM cohort. A Thwaites' Diagnostic Score of ≤ 4 was associated with TBM. Among the Thwaites' Diagnostic Scoring parameters, only blood WBC count and CSF total WBC count varied significantly across cohorts. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of Thwaites' Diagnostic Scoring are as follows: 0.891 (95%CI=0.736-0.965); 0.385 (95%CI=0.151-0.677); 0.805 (95%CI=0.646-0.906); 0.556 (95%CI=0.227-0.847); 1.449 (95%CI=0.929-2.259); and 0.281 (95%CI=0.088-0.903) respectively. @*CONCLUSION@#Thwaites’ diagnostic score is helpful in differentiating tuberculous from bacterial meningitis. However, the utility of diagnostic scoring should be validated in larger study population.