Solari et al reported a clinical prediction rule for the diagnosis of tuberculous meningitis for an adult living in Lima, Peru. The authors are from the Institute of Tropical Medicine of Antwerp, Universidad Peruana de CienciasAplicadas, Hospital Nacional Hipolito Unanue, and Gent Unversity.
Patient selection: adult with meningitis
Parameters:
(1) duration of cough in days
(2) CSF WBC count per microliter
(3) CSF adenosine deaminase (ADA) level in U/L
Parameter
Finding
Points
duration of cough
<= 14 days
0
> 14 days
1
CSF WBC count
< 10
0
10 to 500
1
> 500
0
CSF ADA
< 6 U/L
0
>= 6 U/L
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
Score
Risk Group
Percent TB Meningitis
0
low
6%
1 or 2
intermediate
37%
3 to 5
high
89%
Performance:
• The area under the ROC curve is 0.87.
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