[Value of the "Bacterial Meningitis Score" (BMS) for the differential diagnosis of bacterial versus viral meningitis].
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.
Piérart
J
J
ULg.
Lepage
P
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016920:Meningitis, Bacterial / Q000175:diagnosis*; D008587:Meningitis, Viral / Q000175:diagnosis*; D012189:Retrospective Studies; D012720:Severity of Illness Index