Bacterial Meningitis Score

Bacterial Meningitis Score for Children

Total Score: 0

0 points:	Aseptic meningitis very likely
1 point:	Aseptic meningitis less likely
2–6 points:	Bacterial meningitis MORE likely

Instructions

Use in patients aged 29 days to 19 years with CSF WBC ≥ 10 cells/μL. Do not use if patient is critically ill, recently received antibiotics, has a VP shunt or recent neurosurgery, is immunosuppressed, or has another bacterial infection requiring antibiotics (including Lyme disease).

Pitfalls & Clinical Considerations

Not a replacement for clinical judgment. Always integrate clinical exam and context.
Antibiotics before LP may alter CSF findings and affect scoring.
Children with comorbidities (e.g., VP shunt, immune suppression) may not fit this model.
Lab cutoffs vary — apply local reference ranges when available.

References

Nigrovic LE, Kuppermann N, Malley R. Development and validation of a multivariate predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era. Pediatrics. 2002;110:712–719.
Review national and institutional pediatric meningitis guidelines for additional context.