Application of a Prediction Rule to Discriminate Between Aseptic and Bacterial Meningitis in Adults

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.