Neurology Book

http://www.fpnotebook.com/

Nigrovic Clinical Decision Rule

Aka: Nigrovic Clinical Decision Rule, CSF Interpretation for Predicting Bacterial Meningitis, Bacterial Meningitis Score
  1. See Also
    1. Oostenbrink Clinical Decision Rule for Meningitis
  2. Indications
    1. Meningitis evaluation in children
  3. Contraindications: Exclusion Criteria
    1. Neurosurgical history
    2. Immunosuppression
    3. CSF RBC Count >0.1 x10^6/ul
    4. Antibiotic use in last 48 hours
    5. Purpura
  4. Criteria (1 point for each)
    1. CSF Gram Stain positive for organisms
    2. CSF Protein >79 mg/dl
    3. Seizure related to current episode
    4. Peripheral Absolute Neutrophil Count > 10,000 cells/mm3
    5. CSF Absolute Neutrophil Count >1000 cells/mm3
  5. Efficacy
    1. Test Sensitivity: 99%
  6. Interpretation
    1. Positive if presence of any of above (1 or more points)
    2. Suggests higher likelihood of Bacterial Meningitis
  7. References
    1. Nigrovic (2002) Pediatrics 110:712-9

Navigation Tree