PediatricCriteria

Rule of 7s for Lyme Meningitis vs. Bacterial Meningitis in Children

A clinical decision rule derived from pediatric patients in Lyme disease-endemic areas that identifies children at low risk of bacterial meningitis who likely have Lyme neuroborreliosis, thereby potentially avoiding empirical antibacterial therapy and unnecessary lumbar punctures. Uses three '7' thresholds: CSF lymphocytes, duration of fever, and presence of 7th cranial nerve palsy.

Parameters

Rule of 7s — Low-Risk Criteria for Bacterial Meningitis (Favor Lyme Neuroborreliosis)all

CSF Lymphocyte Predominance ≥ 70% (lymphocytes make up ≥70% of CSF WBCs on differential)Fever Duration < 7 Days (illness began less than 7 days ago — rapid onset less typical of indolent Lyme)No 7th Nerve (Facial) Palsy — No facial weakness, droop, or asymmetry observed on examination

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PediatricCriteria

Rule of 7s for Lyme Meningitis vs. Bacterial Meningitis in Children

A clinical decision rule derived from pediatric patients in Lyme disease-endemic areas that identifies children at low risk of bacterial meningitis who likely have Lyme neuroborreliosis, thereby potentially avoiding empirical antibacterial therapy and unnecessary lumbar punctures. Uses three '7' thresholds: CSF lymphocytes, duration of fever, and presence of 7th cranial nerve palsy.

Parameters

Rule of 7s — Low-Risk Criteria for Bacterial Meningitis (Favor Lyme Neuroborreliosis)all

CSF Lymphocyte Predominance ≥ 70% (lymphocytes make up ≥70% of CSF WBCs on differential)Fever Duration < 7 Days (illness began less than 7 days ago — rapid onset less typical of indolent Lyme)No 7th Nerve (Facial) Palsy — No facial weakness, droop, or asymmetry observed on examination

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Fill in the parameters to see your result