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Oostenbrink Clinical Decision Rule for Meningitis

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Oostenbrink Clinical Decision Rule for Meningitis, Dutch Meningitis Prediction Rule

  • See Also
  1. Nigrovic Clinical Decision Rule (for CSF evaluation)
  • Indications
  1. Meningitis evaluation in children
  2. Evaluate need for Lumbar Puncture in children ages 1 month to 15 years old
  • Criteria
  • Sum the Positive Scores
  1. Symptoms
    1. Score 1/day: Main symptom duration (maximum of 10 days)
    2. Score 2: Vomiting
  2. Signs
    1. Score 8: Altered Level of Consciousness
    2. Score 7.5: Meningeal Irritation
    3. Score 6.5: Cyanosis
    4. Score 4: Petechiae
  3. C-Reactive Protein (CRP)
    1. Score 0: CRP <5 mg/dl or <50 mg/L
    2. Score 0.5: CRP 5 to 9.9 mg/dl or 50 to 99 mg/L
    3. Score 1: CRP 10 to 14.9 mg/dl or 100 to 149 mg/L
    4. Score 1.5: CRP 15 to 19.9 mg/dl or 150 to 199 mg/L
    5. Score 2: CRP >20 mg/dl or >200 mg/L
  • Interpretation
  1. Score >8.5 points indicates need for Lumbar Puncture due to Bacterial Meningitis risk
  • References
  1. Oostenbrink (2001) Acta Paediatr 90:611-7 [PubMed]
  2. Oostenbrink (2004) Eur J Epidemiol 19(2):115 [PubMed]