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Application of a prediction rule to discriminate between aseptic and bacterial meningitis in adults
Benjamin R Doolittle1, Amy Alias
1Internal Medicine and Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA. benjamin.doolittle@yale.edu
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.
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