Bacterial Meningitis Score for Children

By Dr. Costa / July 2, 2026

Bacterial Meningitis Score for Children | MedCalcu

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Bacterial Meningitis Score for Children

Estimates whether a child with cerebrospinal-fluid (CSF) pleocytosis is at very low risk of bacterial meningitis. Complete all five predictors to calculate the score.

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Enter clinical findings

Positive CSF Gram stain is weighted at 2 points; every other positive predictor is weighted at 1 point.

1. CSF Gram stain positive Yes = 2 points

No Yes

2. CSF ANC ≥1,000 cells/µL Yes = 1 point

No Yes

3. CSF protein ≥80 mg/dL (800 mg/L) Yes = 1 point

No Yes

4. Peripheral blood ANC ≥10,000 cells/µL Yes = 1 point

No Yes

5. Seizure at (or prior to) initial presentation Yes = 1 point

No Yes

Result

Awaiting answers

— out of 6

Select one answer for each of the five clinical predictors, then calculate.

Intended use

For children aged 29 days to 19 years with CSF pleocytosis (CSF WBC ≥10 cells/µL).
A score of 0 identifies a very-low-risk group only when the child fits the validated population.
Scores above 0 do not diagnose bacterial meningitis; they are not low risk by this rule.

Do not use this score alone in a critically ill child or where there has been recent antibiotic exposure, a ventricular shunt/recent neurosurgery, immunosuppression, or another bacterial infection requiring antibiotics. Escalate urgently when clinical concern for meningitis remains.

Reference

Nigrovic LE et al. JAMA. 2007;297:52–60.
Clinical prediction rule for identifying children with CSF pleocytosis at very low risk of bacterial meningitis

This calculator is for qualified healthcare professionals and supports—not replaces—clinical judgement, local guidance, and urgent assessment.

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Bacterial Meningitis Score for Children

Enter clinical findings

Awaiting answers

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