Bacterial Meningitis Score for Children
Identifies children with CSF pleocytosis at low risk of bacterial meningitis who may not require empirical antibiotics. Score ≥2 or any high-risk feature = treat as bacterial.
Score interpretation
Score 0 — very low risk of bacterial meningitis: 2 of 1714 (0.1 %); negative predictive value 99.9 % (Nigrovic 2007). Both missed cases were < 2 months old.
→ Consider withholding antibiotics; admit for observation; close monitoring required; clinical assessment paramount — do NOT use score alone in toxic-appearing child
Score 1 — intermediate risk. Clinical judgment required.
→ Consider empiric antibiotics; discuss with paediatric specialist; close monitoring
Score ≥2 — bacterial meningitis likely
→ Empiric IV antibiotics immediately (ceftriaxone ± dexamethasone); blood cultures before antibiotics; urgent paediatric and ID review
Interpretation bands for the Bacterial Meningitis Score. Apply clinical judgement and local guidance.
References
- Nigrovic LE et al. Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis. JAMA. 2007;297(1):52–60.
Related
Curated clinical cross-links plus same-class fallbacks.
- Dexamethasone (Paediatric) · Corticosteroid — Croup / Bacterial Meningitis / Post-Extubation Stridor / Cerebral Oedema
- Ibuprofen (Paediatric) · NSAID / Analgesic / Antipyretic
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Morphine (Paediatric) · Opioid Analgesic — Moderate to Severe Pain in Children
- Ceftriaxone (Paediatric) · Third-Generation Cephalosporin — Meningitis / Sepsis / Community-Acquired Pneumonia
- Gentamicin (Paediatric) · Aminoglycoside — Neonatal Sepsis / Gram-Negative Infections in Children
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.