Cerebrospinal fluid pleocytosis in children in the era of bacterial conjugate vaccines: Distinguishing the child with bacterial and aseptic meningitis

Lise E. Nigrovic, Richard Malley, Nathan Kuppermann

Research output: Contribution to journalArticle

7 Scopus citations


Although bacterial meningitis remains an important cause of childhood morbidity and mortality, the incidence of bacterial meningitis has greatly decreased with the advent of polysaccharide-protein conjugate vaccines in the past 2 decades. Most children with cerebrospinal fluid pleocytosis have aseptic rather than bacterial meningitis, raising the possibility that some patients may be managed as outpatients. In this article, we review the changing epidemiology of bacterial meningitis as well as the available clinical decision rules that may assist the clinician in distinguishing aseptic from bacterial meningitis in patients with cerebrospinal fluid pleocytosis.

Original languageEnglish (US)
Pages (from-to)112-120
Number of pages9
JournalPediatric Emergency Care
Issue number2
StatePublished - Feb 2009



  • Aseptic meningitis
  • Bacterial meningitis
  • CSF pleocytosis
  • Pneumococcal conjugate vaccine
  • Prediction model

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

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