Identifying the Importance of Cerebrospinal Fluid C - reactive protein (CSF-CRP) in Establishing a Diagnosis of Acute Bacterial Meningitis

Abstract

Introduction: Acute meningitis is a major cause of death and disability worldwide. Differentiating bacterial from nonbacterial meningitis is very important in deciding on treatment. Bacterial meningitis is a life-threatening neurological condition and needs prompt parenteral antibiotics, compared to viral and aseptic meningitis which carries relatively better outcomes. Aim of the study: The aim of the study was to identify the importance of the CSF-CRP test in diagnosing acute bacterial meningitis. Methods: This cross-sectional observational study was conducted at the Department of Pediatric Medicine, Dhaka Shishu Hospital, Dhaka, Bangladesh. The study duration was 6 months, from January 2017 to June 2017. A total of 100 children visiting the inpatient department of the hospital were selected for the present study following inclusion and exclusion criteria. Result: 57% were diagnosed as bacterial meningitis cases, while 43% were diagnosed with aseptic meningitis. Among the 57 cases of bacterial meningitis, 61.40% belonged to the youngest age group of 0-2 years, while among the aseptic meningitis cases, 37.21% belonged to the age group of 3-6 years. Total WBC and PBN were significantly higher among the bacterial meningitis cases. The sensitivity of CSF-CRP was 89.47%, specificity 90.69%, accuracy 90%, a positive predictive value of 92.72%, and a negative predictive value of 86.66% in diagnosing bacterial meningitis. Conclusion: The study findings conclude CSF-CRP to be an important prognostic factor and initial testing method in diagnosing acute bacterial meningitis. CSF CRP has high diagnostic accuracy in determining the incidence of acute bacterial meningitis.