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Bacterial Meningitis Score for Children

PediatricsInfectious diseasesEmergency medicineBeta toolThis tool is in beta. It has undergone internal validation but still requires additional testing. Always confirm the data entered and the results obtained before clinical use. It should not be used as the sole basis for clinical decisions.

Use only from 2 to 228 months.

months

The rule is only validated when CSF pleocytosis is present at 10 cells/µL or higher.

cells/µL
Antibiotics before lumbar punctureIf yes, do not use this calculator.
Other major exclusion presentIncludes critical illness, toxic appearance, immunosuppression, ventriculoperitoneal shunt, recent neurosurgery, petechiae or purpura, or another bacterial infection already requiring antibiotics.
CSF Gram stain positiveA positive Gram stain counts as one present criterion.

Adds one point at 1000 cells/µL or higher.

cells/µL

Adds one point at 80 mg/dL or higher.

mg/dL

Adds one point at 10000 cells/µL or higher.

cells/µL
Seizure before or at presentationAdds one point if a seizure occurred before or at presentation.

Clinical noticeTransparent clinical support only. Interpret with full medical assessment and microbiologic follow-up.

Context and use

Fórmula

BMS = positive Gram stain + [CSF ANC >= 1000] + [CSF protein >= 80] + [peripheral ANC >= 10000] + [seizure before or at presentation].

In otherwise eligible children with CSF pleocytosis, the rule distinguishes a score of 0 from 1 or more.

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Nutrition and metabolism

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Estimates basal energy expenditure in kcal/day using the original Harris-Benedict equations.

Certifications and Compliance

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