The presence of one or both of the following can be used to diagnose meningitis or ventriculitis:
(1) micro-organisms cultured from the cerebrospinal fluid (CSF)
(2) all of the following:
(2a) one or more of the following:
(2a1) fever (> 38°C, rectal if <= 1 years)
(2a2) hypothermia if <= 1 year (rectal temperature < 37°C)
(2a3) apnea if <= 1 year of age
(2a4) bradycardia if <= 1 year of age
(2a5) stiff neck
(2a6) meningeal signs
(2a7) cranial nerve signs
(2a8) irritability
(2a9) headache if > 1 year of age
(2b) one or more of the following:
(2b1) positive Gram stain on the CSF
(2b2) positive blood culture for micro-organisms
(2b3) positive antigen test on blood, CSF or urine
(2b4) increased WBCs, elevated protein and decreased glucose in the CSF
(2b5) diagnostic serum serology (single IgM antibody titer or 4-fold increase in IgG in paired serum specimens
(2c) no other explanation
(2d) The physician started appropriate antibiotic therapy if the diagnosis was made antemortem.
Meningitis in a neonate may be acquired transplacentally or it may be health care associated.
The diagnosis of meningitis includes:
(1) spinal abscess with meningitis
(2) meningoencephalitis
(3) infection of a CSF shunt acquired within 1 year of placement
