Sensitivity of the bacterial meningitis score in 889 children with bacterial meningitis.

Objective: To validate sensitivity of the bacterial meningitis score (BMS) in a large population of children with bacterial meningitis (BM).
Study Design: Secondary analysis of prospective data for children presenting with BM to a hospital emergency department between January 2001 and February 2005. The BMS was applied to all children with acute BM using the same inclusion criteria proposed by the authors of the rule. The sensitivity of the rule was calculated.
Results: Of the 900 children aged 29 days to 18 years with acute BM who met all inclusion criteria, 889 had enough data for assigning the BMS. Use of the BMS correctly identified 884 children with BM, for 99.6% sensitivity (95% confidence interval: 98.9% to 99.8%).
Conclusions: The sensitivity of the BMS to detect disease was very high, but a few cases of BM were missed. Further refinements of the BMS may be warranted to lower the false-negative rate.