[Value of the "Bacterial Meningitis Score" (BMS) for the differential diagnosis of bacterial versus viral meningitis]

Author(s): Piérart J, Lepage P

Abstract

The "Bacterial Meningitis Score" (BMS) has been designed to identify children at low (BMS = 0) or high (BMS > or = 2) risk of bacterial meningitis (M). Its calculation is simple; it is based on 5 different items: Gram stain, seizure at or before presentation, peripheral white blood cell count (WBC), cerebrospinal fluid (CSF) WBC and CSF protein concentration. As of today, it has been validated in one single study in the United States. The purpose of this study is to evaluate the BMS performance in children hospitalized for M over a 5 years period. The medical records of 277 patients diagnosed with M, aged 29 days to 15 years and hospitalized in the Department of Pediatrics of the CHR Citadelle Hospital in Liège between 1999 and 2003 were analysed. Among the 277 hospitalised cases, there were 29 bacterial (10,5%) and 248 viral (89,5%) M. For patients whose BMS < 2, we found 100% of viral M. For those with BMS > or = 2, 59,3% had a bacterial M and 40,7% had a viral M. 23% of the children with BMS < 2 were treated with antibiotics; 17% of children with BMS = 2 were not been treated on admission. The BMS is an easily applicable method that could allow reduce the unnecessary use of antibiotics.

Similar Articles

Validation of caregiver interviews to diagnose common causes of severe neonatal illness

Author(s): Kalter HD, Hossain M, Burnham G, Khan NZ, Saha SK, et al.

The World Health Report 1995--bridging the gaps

Author(s): [No authors listed]

Bacteraemia in patients presenting with fever

Author(s): Petit PL, Haarlem JV, Poelman M, Haverkamp MC, Wamola IA

Neonatal deaths in Calabar, Nigeria

Author(s): Asindi AA, Ekanem AD

Mortality pattern among Nigerian children in the 1980s

Author(s): Asindi AA, Ibia EO, Udo JJ

Septicaemia in high risk neonates at a teaching hospital in Ile-Ife, Nigeria

Author(s): Adejuyigbe EA, Adeodu OO, Ako-Nai KA, Taiwo O, Owa JA

Kernicterus: still a concern

Author(s): Juretschke LJ

Rehospitalisation after birth hospitalisation: patterns among infants of all gestations

Author(s): Escobar GJ, Greene JD, Hulac P, Kincannon E, Bischoff K, et al.

Neonatal morbidity and mortality in Nigeria

Author(s): Owa JA, Osinaike AI

Risk factors for ne onatal mortality in a regional tertiary hospital in Nigeria

Author(s): Ezechukwu CC, Ugochukwu EF, Egbuonu I, Chukwuka JO

Pattern of admissions to neonatal unit

Author(s): Parkash J, Das N

[Treatment of neonatal jaundice]

Author(s): Hansen TW

Central Nervous System Infections

Author(s): Prober CG

Salmonella meningitis in infancy

Author(s): SMITH ES

Malaria in the first 6 months of life in urban African infants with anemia

Author(s): Afolabi BM, Salako LA, Mafe AG, Ovwigho UB, Rabiu KA, et al.

Rev

Author(s): Whaley LF, Wong DL

Epidemiology and risk factors for early onset sepsis among very-low-birthweight infants

Author(s): Klinger G, Levy I, Sirota L, Boyko V, Reichman B, et al.

Septicaemia among neonates with tetanus

Author(s): Antia-Obong OE, Ekanem EE, Udo JJ, Utsalo SJ

Bacterial isolates from blood cultures of children with suspected septicaemia in Calabar, Nigeria

Author(s): Meremikwu MM, Nwachukwu CE, Asuquo AE, Okebe JU, Utsalo SJ

Half a decade of neonatal sepsis, Riyadh, Saudi Arabia

Author(s): Haque KN, Chagia AH, Shaheed MM

A graphical decision-theoretic model for neonatal jaundice

Author(s): Gómez M, Bielza C, Fernández del Pozo JA, Ríos-Insua S

Neonatal Tetanus in Port Harcourt

Author(s): Orumabo RS, Mbagbaw LT

Oxygen concentration and pulmonary hemodynamics in newborn lambs with pulmonary hypertension

Author(s): Lakshminrusimha S, Swartz DD, Gugino SF, Ma CX, Wynn KA, et al.

Oxidative stress in asphyxiated term infants resuscitated with 100% oxygen

Author(s): Vento M, Asensi M, Sastre J, Lloret A, García-Sala F, et al.

Neonatal salmonella meningitis complicated by cerebral abscesses

Author(s): West SE, Goodkin R, Kaplan AM