{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T07:26:21Z","timestamp":1781076381851,"version":"3.54.1"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>New biomarkers like procalcitonin and C-reactive protein may help design an accurate decision support tool used to identify children with pleocytosis at low or high risk of bacterial meningitis. Our objective was to develop and validate a score (that we call the meningitis score for emergencies [MSE]) to distinguish bacterial meningitis from aseptic meningitis in children with pleocytosis when initially evaluated at the emergency department.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We included children between 29 days and 14 years old with meningitis admitted to 25 Spanish emergency departments. A retrospective cohort from between 2011 and 2016 was used as the derivation set and a prospective cohort recruited during 2017 and 2018 was used as the validation set.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Among the 1009 patients included, there were 917 cases of aseptic meningitis and 92 of bacterial meningitis. Using multivariable logistic regression analysis, we identified the following predictors of bacterial meningitis from the derivation set: procalcitonin &amp;gt;1.2 ng\/mL, cerebrospinal fluid (CSF) protein &amp;gt;80 mg\/dL, CSF absolute neutrophil count &amp;gt;1000 cells per mm3, and C-reactive protein &amp;gt;40 mg\/L. Using the derivation set, we developed the MSE, assigning 3 points for procalcitonin, 2 points for CSF protein, and 1 point for each of the other variables. An MSE \u22651 predicted bacterial meningitis with a sensitivity of 100% (95% confidence interval [CI]: 95.0%\u2013100%), a specificity of 83.2 (95% CI: 80.6\u201385.5), and a negative predictive value of 100% (95% CI 99.4\u2013100.)<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>The MSE accurately distinguishes bacterial from aseptic meningitis in children with CSF pleocytosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2020-1126","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T12:25:27Z","timestamp":1598358327000},"source":"Crossref","is-referenced-by-count":28,"title":["Clinical Prediction Rule for Distinguishing Bacterial From Aseptic Meningitis"],"prefix":"10.1542","volume":"146","author":[{"given":"Santiago","family":"Mintegi","sequence":"first","affiliation":[{"name":"Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Osakidetza and University of the Basque Country, Universidad del Pa\u00eds Vasco\/Euskal Herriko Unibertsitatea, Bilbao, Basque Country, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Osakidetza and University of the Basque Country, Universidad del Pa\u00eds Vasco\/Euskal Herriko Unibertsitatea, Bilbao, Basque Country, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Mart\u00edn","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department, Ni\u00f1o Jesus University Children\u2019s Hospital, Madrid, Spain; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Dur\u00e1n","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department, Regional University Hospital of Malaga, Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunate","family":"Arana-Arri","sequence":"additional","affiliation":[{"name":"Scientific Coordination Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Osakidetza, Bilbao, Basque Country, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina Livana","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Osakidetza and University of the Basque Country, Universidad del Pa\u00eds Vasco\/Euskal Herriko Unibertsitatea, Bilbao, Basque Country, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Benito","sequence":"additional","affiliation":[{"name":"Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Osakidetza and University of the Basque Country, Universidad del Pa\u00eds Vasco\/Euskal Herriko Unibertsitatea, Bilbao, Basque Country, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Hern\u00e1ndez-Bou","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department, Hospital Sant Joan de D\u00e9u, Barcelona, Catalonia, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Meningitis Group of the Spanish Society of Pediatric Emergencies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2020,9,1]]},"reference":[{"issue":"12","key":"2021121020312366700_B1","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1097\/00006454-199912000-00002","article-title":"Enterovirus infections: diagnosis and treatment","volume":"18","author":"Sawyer","year":"1999","journal-title":"Pediatr Infect Dis J"},{"issue":"1","key":"2021121020312366700_B2","first-page":"14","article-title":"Meningitis by enterovirus in pediatrics. 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