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The Application of Bacterial Meningitis Score for Bacterial Meningitis and Enteroviral Meningitis in Pediatric Patients / 대한소아신경학회지
Journal of the Korean Child Neurology Society ; (4): 39-43, 2017.
Artículo en Coreano | WPRIM | ID: wpr-139269
ABSTRACT

PURPOSE:

Bacterial meningitis score (BMS) has been introduced as a clinical predictive parameter for diagnosing cerebrospinal fluid (CSF) pleocytosis in children at very low risk of bacterial meningitis in the postconjugate vaccine era. This study aimed to examine the usefulness of the BMS and to identify an additional index to distinguish between enteroviral meningitis and bacterial meningitis.

METHODS:

We retrospectively included 289 patients with enteroviral meningitis and 10 patients with bacterial meningitis between the aged 2 months to 16 years. We applied the BMS to all the included patients, and compared the initial laboratory and clinical characteristics between the two groups.

RESULTS:

Of the 210 patients categorized as having a very low risk of bacterial meningitis based on BMS, 2 (1%) had bacterial meningitis, both of whom were younger than 3 months. The sensitivity, specificity, and negative predictive value of the BMS for bacterial meningitis were 80%, 72%, and 99%, respectively. Compared with patients with enteroviral meningitis, those with bacterial meningitis were younger (0.3 years vs. 5.0 years, P<0.01), had higher leukocyte count (530/mm³ vs. 43/mm³, P=0.04), neutrophil count (490/mm³ vs. 20/mm³, P<0.01), and protein level (106 mg/dL vs. 30 mg/dL, P<0.01) in the CSF, and increased serum C-reactive protein (CRP) level (79 mg/L vs. 4.5 mg/L, P<0.01).

CONCLUSION:

Although the BMS is a useful clinical predictive parameter for identifying children with CSF pleocytosis who are at very low risk of bacterial meningitis, it should be applied with caution in young infants. In addition to applying BMS, clinical parameters such as CSF profiles and serum CRP levels are useful in clinical decision making for the management of children with CSF pleocytosis.
Asunto(s)

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Proteína C-Reactiva / Líquido Cefalorraquídeo / Estudios Retrospectivos / Sensibilidad y Especificidad / Meningitis Bacterianas / Toma de Decisiones Clínicas / Recuento de Leucocitos / Leucocitosis / Meningitis / Meningitis Aséptica Tipo de estudio: Estudio diagnóstico / Estudio observacional / Estudio pronóstico Límite: Niño / Humanos / Lactante Idioma: Coreano Revista: Journal of the Korean Child Neurology Society Año: 2017 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Proteína C-Reactiva / Líquido Cefalorraquídeo / Estudios Retrospectivos / Sensibilidad y Especificidad / Meningitis Bacterianas / Toma de Decisiones Clínicas / Recuento de Leucocitos / Leucocitosis / Meningitis / Meningitis Aséptica Tipo de estudio: Estudio diagnóstico / Estudio observacional / Estudio pronóstico Límite: Niño / Humanos / Lactante Idioma: Coreano Revista: Journal of the Korean Child Neurology Society Año: 2017 Tipo del documento: Artículo