From: Seizures in adults with suspected central nervous system infection
 | Neurological infection | Other diagnoses | Sens (95%CI) | Spec (95%CI) | PPV (95%CI) | NPV (95%CI) | ||
---|---|---|---|---|---|---|---|---|
 | Present | Absent | Present | Absent |  |  |  |  |
Headache | 10 | 10 | 23 | 48 | 50% (27%—73%) | 68% (55% – 78%) | 30% (20%—43%) | 83 (75%—88%) |
Nausea/vomiting | 6 | 15 | 20 | 53 | 29% (11%—52%) | 73% (61%—82%) | 23% (12%—40%) | 78% (72%—83%) |
Immunocompromised | 10 | 17 | 43 | 54 | 37 (19% – 57%) | 56 (45%—66%) | 19% (12%—29%) | 76% (69%—82%) |
Altered mental status (GCS ≤ 14) | 24 | 3 | 83 | 13 | 89% (71%—98%) | 14% (7%—22%) | 22% (20%—25%) | 81% (57%—94%) |
Coma (GCS ≤ 8) | 12 | 15 | 30 | 66 | 44% (25%—65%) | 69% (58%—78%) | 29% (19%—40%) | 81% (75%—86%) |
Neck stiffness | 5 | 15 | 6 | 70 | 25% (8%—49%) | 92% (84%—97%) | 45% (22%—71%) | 82% (78%—85%) |
Generalized seizure | 16 | 8 | 54 | 35 | 67% (45%-84%) | 39% (29%—59%) | 23% (18%—29%) | 81% (70%—89%) |
Diast BP < 50 mmHg | 3 | 24 | 7 | 88 | 11% (2%—29%) | 93% (85%—97%) | 30% (11%—61%) | 79% (66%—82%) |
Tachycardia | 7 | 20 | 10 | 85 | 26% (11%—46%) | 89% (81%—95%) | 41% (23%—62%) | 81% (77%—84%) |
Fever > 38.0 °C | 15 | 12 | 26 | 69 | 56% (35%—75%) | 73% (63%—81%) | 37% (27%—48%) | 85% (79%—89%) |
Focal neurological abnormalities | 8 | 19 | 45 | 52 | 30% (14%—50%) | 54% (43%—64%) | 15% (9%—25%) | 73% (67%—79%) |
Blood leukocytose (≥ 10.5) | 15 | 12 | 56 | 40 | 56% (36%—75%) | 42% (32%—52%) | 21% (16%—28%) | 77% (67%—84%) |
CRP > 5 mg/L | 19 | 7 | 53 | 34 | 73% (52%—88%) | 39% (29%—50%) | 26% (21%—32%) | 83% (71%—91%) |
CRP > 40 mg/L | 13 | 13 | 19 | 68 | 50% (30%—70%) | 78% (68%—86%) | 41% (28%—54%) | 84% (78%—89%) |
CSF leukocytes ≥ 5/mm3 | 24 | 2 | 27 | 70 | 92% (75%—99%) | 72% (62%—81%) | 47% (39%—56%) | 97% (90%—99%) |
CSF leukocytes > 100/mm3 | 15 | 11 | 1 | 96 | 58% (37%—77%) | 99% (94%—100%) | 94% (67%—99%) | 90% (85%—93%) |
CSF protein > 0.6 g/L | 18 | 9 | 25 | 72 | 67% (46%—83%) | 74% (74%—83%) | 42% (32%—53%) | 89% (82%—93%) |
CSF protein > 2 g/L | 8 | 19 | 3 | 94 | 30% (14%—50%) | 97% (91%—99%) | 72% (43%—90%) | 83% (79%—86%) |
CSF pressure > 22 mm H2O | 7 | 3 | 21 | 49 | 70% (35%—93%) | 70% (58%—80%) | 25% (16%—36%) | 94% (86%—98%) |
CSF:blood glucose ratio < 0.6 | 21 | 4 | 53 | 37 | 84% (64%—95%) | 41% ( 31%—52%) | 28% (24%—34%) | 90% (78%—95%) |