title: Application of a prediction rule to discriminate between aseptic and bacterial meningitis in adults.
abstract: BACKGROUND
  Differentiating between aseptic and bacterial meningitis presents a difficult diagnostic challenge. Accurately ruling out bacterial meningitis may reduce unnecessary hospitalization, patient morbidity, and utilization of resources. This study applies a prediction rule previously developed in the pediatric population to an adult cohort.
  
  
  METHODS
  We performed a retrospective chart review of all patients admitted to an urban community hospital in the United States between 1994 and 2007.
  
  
  RESULTS
  One hundred eleven patients met the inclusion criteria. Twenty-two (20%) had bacterial meningitis and 89 (80%) had aseptic meningitis. The prediction rule generated a negative predictive value of 100% and a sensitivity of 100%, successfully ruling out all patients with aseptic meningitis.
  
  
  CONCLUSIONS
  The prediction rule, previously validated in a pediatric population, was accurate in ruling out bacterial meningitis in an adult cohort. Prospective validation in an adult population is warranted.
authors.affiliation: Internal Medicine and Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA. benjamin.doolittle@yale.edu
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Doolittle
authors.forename: Amy
authors.initials: A
authors.lastname: Alias
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003237:Connecticut / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000175:diagnosis* / Q000453:epidemiology*; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology