Calculater_Risk LUMBAR PUNCTURE DECISION MAKING TOOL
AMONG NEONATES WITH SUSPICION
OF BACTERIAL MENINGITIS
Doctor
This calculator evaluates the risk stratification of bacterial meningitis in neonates, helping clinicians for bacterial meningitis screening and lumbar puncture procedure decision making.

The Data you input will not be recorded and stored.
This is for your reference only, as peer review is ongoing
Calculator
Items Value
Age
(day)
day
Antibiotic pretreatment before admission
(Yes or No)
Fever (>38℃)
(Yes or No)
Definite source of infection
(Yes or No)
Neurological manifestation
(Yes, No)
CRP
(mg/L)
mg/L
PCT
(ng/ml)
ng/ml
Result
Risk =
Subjects How to use Note Algorithm
Subjects Return to TOP
  • The algorithm was derived from 1072 Chinese neonates aged 0-28 days suspected of cental nervous system infection and accepted lumbar puncture.
  • Neonate bacterial meningitis was confirmed by pathogenic bacteria investigation and lumber puncture.
How to use Return to TOP
  • After entering measurements of fever (Yes, No), definite source of infection (Yes, No), neurological manifestation (Yes, No), CRP (mg/L) and PCT (ng/dl), the risk stratification of neonate bacterial meningitis was automatically classified as at high risk and low risk according to the sequential algorithm presented at the bottom of the webpage.
  • If a patient is at high risk, he/she is strongly suggested to administrate lumbar puncture.
  • If a patient is at low risk, lumbar puncture is not urgent , and a short-term observation and reassessment in the management of these patients may be more appropriate.
Note Return to TOP
  • Fever: temperature>38℃
  • Neurological manifestation: present one or more signs including seizure, abnormal tension, irritability, and bulging anterior fontanelle.
  • Definite source of bacterial infection: with any source of infection as follows: impetigo, urinary tract infection (UTI), omphalitis, respiratory infection, and purulent arthritis.
  • CRP and PCT should be administrated within 24 hours on admission.
  • Patients older than 28 days or with traumatic LP or with antibiotic pretreatment are not applicable to this calculator.
Algorithm Return to TOP
The Sequential algorithm
The “Step-by-Step” algorithm
Presence fever with a definite source of infection?
No: with fever but absence of infection source.
Yes: with fever and definite source of infection.
Chen et al, Derivation and validation of a Sequential Approach to Identify Full-term Neonates at Low Risk of Bacterial Meningitis.

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