# Bacterial Meningitis Score (Nigrovic) Bacterial Meningitis Score Status: LIVE Price: $0.005 USDC `GET /api/calc/bacterial_meningitis` HTML: https://magentlab.com/docs/bacterial-meningitis Markdown: https://magentlab.com/docs/bacterial-meningitis.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the Nigrovic 2002 Bacterial Meningitis Score weights for children with CSF pleocytosis and return very_low_risk (0) or not_low_risk (≥1). ## When to use When an agent needs the published Bacterial Meningitis Score point total and band and must not invent a later numeric cutoff, a meningitis diagnosis, or an antibiotic or LP order. ## When not to use - Not a medical device and not a meningitis diagnosis or an antibiotic/LP order. magent does not examine the patient. - Applies to children with CSF pleocytosis as in Nigrovic 2002. It is not a neonatal meningitis score. - magent does not stain CSF, count neutrophils, assay protein, or witness a seizure. All five inputs are caller-assigned flags. - CSF Gram stain true scores 2 points in Nigrovic 2002. It does not score 1. - very_low_risk is score 0 (lack all criteria). not_low_risk is score ≥1. Do not apply a later numeric cutoff. ## Formula ``` Bacterial Meningitis Score = csf_gram_stain 2 + csf_anc_ge_1000 1 + csf_protein_ge_80 1 + peripheral_anc_ge_10000 1 + seizure 1; Nigrovic 2002; max 6; very_low_risk 0, not_low_risk ≥1 ``` ## Citation [Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era](https://doi.org/10.1542/peds.110.4.712) Nigrovic LE, Kuppermann N, Malley R Pediatrics. 2002;110(4):712-719 DOI: [10.1542/peds.110.4.712](https://doi.org/10.1542/peds.110.4.712) ## Worked example ### All flags false Given: `csf_anc_ge_1000=false, csf_gram_stain=false, csf_protein_ge_80=false, peripheral_anc_ge_10000=false, seizure=false` 1. All five caller-assigned flags false → 0 2. Score = 0 (max 6); bacterial_meningitis_band = very_low_risk ### CSF Gram stain true Given: `csf_anc_ge_1000=false, csf_gram_stain=true, csf_protein_ge_80=false, peripheral_anc_ge_10000=false, seizure=false` 1. csf_gram_stain → 2; remaining flags 0 2. Score = 2 (max 6); bacterial_meningitis_band = not_low_risk (≥1) ## Also searched as - Bacterial Meningitis Score - Nigrovic 2002 - Nigrovic BMS - pediatric bacterial meningitis score - CSF Gram stain meningitis - very low risk bacterial meningitis ## Parameters - `csf_gram_stain` (boolean, required): Positive CSF Gram stain as assigned by the caller (Nigrovic 2002). true scores 2, not 1. magent does not stain CSF. - `csf_anc_ge_1000` (boolean, required): CSF ANC ≥1000 cells/µL as assigned by the caller (Nigrovic 2002). true scores 1. magent does not count neutrophils. - `csf_protein_ge_80` (boolean, required): CSF protein ≥80 mg/dL as assigned by the caller (Nigrovic 2002). true scores 1. magent does not assay protein. - `peripheral_anc_ge_10000` (boolean, required): Peripheral ANC ≥10 000 cells/µL as assigned by the caller (Nigrovic 2002). true scores 1. magent does not count neutrophils. - `seizure` (boolean, required): Seizure at or before presentation as assigned by the caller (Nigrovic 2002). true scores 1. magent does not witness a seizure. ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/bacterial_meningitis` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "csf_anc_ge_1000": "false", "csf_gram_stain": "false", "csf_protein_ge_80": "false", "peripheral_anc_ge_10000": "false", "seizure": "false" }, { "csf_anc_ge_1000": "false", "csf_gram_stain": "false", "csf_protein_ge_80": "false", "peripheral_anc_ge_10000": "false", "seizure": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/bacterial-meningitis Example 200: ```json { "count": 2, "path": "/api/calc/bacterial_meningitis", "items": [ { "components": [ { "factor": "csf_gram_stain", "points": 0, "present": false }, { "factor": "csf_anc_ge_1000", "points": 0, "present": false }, { "factor": "csf_protein_ge_80", "points": 0, "present": false }, { "factor": "peripheral_anc_ge_10000", "points": 0, "present": false }, { "factor": "seizure", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Nigrovic LE, Kuppermann N, Malley R", "doi": "10.1542/peds.110.4.712", "id": "nigrovic-2002", "pmid": "12359784", "source": "Pediatrics. 2002;110(4):712-719", "title": "Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era" }, "formula": "bacterial_meningitis", "formula_expression": "Bacterial Meningitis Score = csf_gram_stain 2 + csf_anc_ge_1000 1 + csf_protein_ge_80 1 + peripheral_anc_ge_10000 1 + seizure 1; Nigrovic 2002; max 6; very_low_risk 0, not_low_risk ≥1", "max_score": 6, "score": 0, "bacterial_meningitis_band": "very_low_risk" }, { "components": [ { "factor": "csf_gram_stain", "points": 0, "present": false }, { "factor": "csf_anc_ge_1000", "points": 0, "present": false }, { "factor": "csf_protein_ge_80", "points": 0, "present": false }, { "factor": "peripheral_anc_ge_10000", "points": 0, "present": false }, { "factor": "seizure", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Nigrovic LE, Kuppermann N, Malley R", "doi": "10.1542/peds.110.4.712", "id": "nigrovic-2002", "pmid": "12359784", "source": "Pediatrics. 2002;110(4):712-719", "title": "Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era" }, "formula": "bacterial_meningitis", "formula_expression": "Bacterial Meningitis Score = csf_gram_stain 2 + csf_anc_ge_1000 1 + csf_protein_ge_80 1 + peripheral_anc_ge_10000 1 + seizure 1; Nigrovic 2002; max 6; very_low_risk 0, not_low_risk ≥1", "max_score": 6, "score": 0, "bacterial_meningitis_band": "very_low_risk" } ] } ``` ## Response fields - `formula` (string): bacterial_meningitis - `formula_expression` (string): Exact expression used - `score` (integer): Bacterial Meningitis Score points 0-6 - `max_score` (integer): Always 6 - `bacterial_meningitis_band` (string): very_low_risk when score is 0, not_low_risk when score ≥1 (Nigrovic 2002 lack-all-criteria rule). Not a meningitis diagnosis or an antibiotic/LP order. - `components` (array): Per-factor points - `citation` (object): Nigrovic 2002 Pediatrics citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "csf_gram_stain", "points": 0, "present": false }, { "factor": "csf_anc_ge_1000", "points": 0, "present": false }, { "factor": "csf_protein_ge_80", "points": 0, "present": false }, { "factor": "peripheral_anc_ge_10000", "points": 0, "present": false }, { "factor": "seizure", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Nigrovic LE, Kuppermann N, Malley R", "doi": "10.1542/peds.110.4.712", "id": "nigrovic-2002", "pmid": "12359784", "source": "Pediatrics. 2002;110(4):712-719", "title": "Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era" }, "formula": "bacterial_meningitis", "formula_expression": "Bacterial Meningitis Score = csf_gram_stain 2 + csf_anc_ge_1000 1 + csf_protein_ge_80 1 + peripheral_anc_ge_10000 1 + seizure 1; Nigrovic 2002; max 6; very_low_risk 0, not_low_risk ≥1", "max_score": 6, "score": 0, "bacterial_meningitis_band": "very_low_risk" } ``` ## Errors - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [Glasgow Coma Scale](https://magentlab.com/docs/gcs) — Compute the Glasgow Coma Scale as the sum of caller-assigned eye, verbal, and motor integers. The 1974 or 1976 edition is required. - [SIRS](https://magentlab.com/docs/sirs) — Compute the Bone 1992 ACCP/SCCM SIRS criteria from temperature, heart rate, respiratory rate, and WBC, with optional PaCO2 and band percent. - [PECARN pediatric head CT](https://magentlab.com/docs/pecarn-head) — Apply the Kuppermann 2009 PECARN prediction trees and return high, intermediate, or low risk of clinically important brain injury from caller-assigned findings after pediatric head trauma. ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.