Application of a prediction rule to discriminate between aseptic and bacterial meningitis in adults

Hosp Pract (1995). 2009 Dec;37(1):93-7. doi: 10.3810/hp.2009.12.259.

Abstract

Introduction: 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.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Connecticut / epidemiology
  • Diagnosis, Differential
  • Female
  • Hospitals, Urban / statistics & numerical data
  • Humans
  • Male
  • Meningitis, Aseptic / diagnosis*
  • Meningitis, Aseptic / epidemiology*
  • Meningitis, Bacterial / diagnosis*
  • Meningitis, Bacterial / epidemiology*
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • United States / epidemiology