C - reactive protein of cerebrospinal fluid, as a sensitive approach for diagnosis of neonatal meningitis

Abstract

Background: Meningitis, is a potentially life-threatening condition that can rapidly progress to permanent brain damage, neurologic problems, and even death. Bacteria and viruses cause the great majority of meningitis disease in infants and children. CRP is used mainly as a marker of inflammation.Objective: This study was conducted to assess the diagnostic value of CSF-CRP levels for differentiating between septic (bacterial) and aseptic infantile meningitis.Methods: 49 hospitalized infants aged less than two months with suspected meningitis were enrolled in a cross-sectional analytic study. All of patients underwent lumbar puncture to obtain CSF. smears, cultures, cytological and biochemical analysis and latex agglutination testing were carried out on all CSF samples. Latex agglutination test was carried out on all CSF samples using a commercially available kit. CSF-CRP level of all infants was measured using the immunoturbidometric technique.Results: Of 49 infants in this study, 20 and 29 cases were diagnosed as septic and aseptic meningitis, respectively. The CRP levels were obtained as 0.95±0.68 mg/L in septic and 0.16±0.36 mg/L in aseptic meningitis groups and this difference was statistically significant (p<0.001) between the two groups (0.79±0.32 mg/L). Based on the ROC curve, cut off levels for CRP was obtained 0.17 mg/L. At this level, there was 95% sensitivity and 86% specificity to differentiate septic and aseptic meningitis.Conclusion: CSF-CRP has suitable diagnostic value in distinguishing between infantile bacterial from aseptic meningitis especially in cases of negative bacterial culture of the blood and spinal fluid.Keywords: C-reactive protein, cerebrospinal fluid, septic/aseptic meningitis, infant, diagnostic value.

Traditional and molecular methods for diagnosing bacterial meningitis in Erbil city, Iraq

“…Studies performed by Dashti and coworkers 15 and Javadinia and coworkers 44 , found that CRP levels were elevated in cases of bacterial meningitis which agree with the current study.…”

Diagnostic accuracy of inflammatory markers in adults with suspected central nervous system infections

“…Previous studies suggested that both CRP, IL-6 and IL-1β are potentially helpful in the diagnosis of bacterial meningitis. 7 , 8 , 16 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 Sample sizes in these studies were often small and populations were not representable for clinical practice. Our study confirms that these results stay robust in a clinically representative population and after validation.…”

Meta-analysis of Cerebrospinal Fluid Cell Count and Biochemistry to Diagnose Meningitis in Infants Aged < 90 Days

“…Recently, normative ranges were derived from studies on nearly asymptomatic neonates, but these values cannot be used as thresholds for diagnosing bacterial meningitis in symptomatic neonates 18 . Newer CSF biomarkers have been evaluated in a limited number of studies, but these are not yet ready for introduction in clinical practice [19][20][21][22][23][24] .…”

“…18 Newer CSF biomarkers have been evaluated in a limited number of studies, but these are not yet ready for introduction in clinical practice. 19 20 21 22 23 24…”

“…18 Newer CSF biomarkers have been evaluated in a limited number of studies, but these are not yet ready for introduction in clinical practice. [19][20][21][22][23][24] Although many studies on the role of CSF cytochemistry in neonates and young infants have been published, the thresholds used varied widely across the studies. As a result, the reported sensitivities and specificities also varied.…”