Serum Procalcitonin in Septic Meningitis

Prasad, Rajniti; Kapoor, Rishi; Mishra, Om P.; Srivastava, Ragini; Singh, Utpal

doi:10.1007/s12098-012-0933-3

Cited by 28 publications

(19 citation statements)

References 18 publications

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“…Prasad et al reported serum PCT to be a good marker for the diagnosis of septic meningitis in children, and was able to differentiate between septic and aseptic meningitis at a higher cut-off of 15 ng/mL. 13 Whether raised serum PCT is reflected in CSF or it is produced by CNS cells is debatable. Raddant and Russo observed that reactive oxygen species in response to neuroinflammation activate expression of procalcitonin (proCT) in trigeminal ganglion of mouse model.…”

Section: Discussionmentioning

confidence: 99%

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Utility of Cerebrospinal Fluid and Serum Procalcitonin for the Diagnosis of Neonatal Meningitis

et al. 2020

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Objective Positive CSF culture is the gold standard for the diagnosis of meningitis but it carries poor sensitivity. CSF procalcitonin (PCT) is shown to have some utility for the diagnosis of meningitis though there are limited studies in neonatal age group. We planned this study to compare CSF, serum, and CSF to serum PCT levels in neonates with confirmed, probable, and nonmeningitis groups to determine its optimal cut-off in CSF and serum for diagnosing meningitis Study Design Sixty-seven neonates who qualified for lumbar puncture were enrolled in the study. Neonates were categorized into confirmed meningitis, i.e., CSF cytochemistry and culture positive (N = 17), probable meningitis, i.e., CSF cytochemistry positive but culture negative (N = 25) and nonmeningitis, i.e., both cytochemistry and culture negative (N = 25). CSF and serum samples were stored at −80°C for PCT assay. Results Significant difference was seen in mean of CSF PCT in neonates with confirmed (0.31 ng/mL), probable (0.22 ng/mL), and nonmeningitis (0.11 ng/mL) groups. Similarly, significant difference was observed in serum PCT levels also, though the ratio of serum to CSF PCT was comparable. At cut-off of 0.2 ng/mL, CSF PCT had sensitivity of 95.2% and specificity of 96% in the diagnosis of meningitis. Conclusion CSF PCT is more specific marker for the diagnosis of neonatal meningitis as compared with serum PCT and CSF to serum PCT ratio. Key Points

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Section: Discussionmentioning

confidence: 99%

“…12 Serum PCT levels have also been reported to be increased in adults and children with bacterial meningitis. 13,14 However, the significance of CSF PCT in neonatal meningitis has not been studied widely. Jereb et al in their preliminary work reported higher CSF PCT levels in children with meningitis.…”

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Utility of Cerebrospinal Fluid and Serum Procalcitonin for the Diagnosis of Neonatal Meningitis

et al. 2020

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“…Therefore, the PCT test has been considered a useful tool for early diagnosis of infection [21]. In other studies, PCT was found to be a useful biomarker to distinguish between bacterial and viral meningitis [22]. Moreover, in Korea, several published studies have focused on the value of laboratory markers in discriminating serious bacterial infections, and Hur et al [23] studied the diagnostic value of PCT and CRP simultaneously using blood samples from 1,270 patients with blood culture-positive sepsis.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of C-reactive protein for the diagnosis of meningitis in febrile infants under 3 months of age in the emergency department

Lee¹,

Yu²,

So³

2020

Yeungnam Univ J Med

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Background: Fever is a common cause of pediatric consultation in the emergency department. However, identifying the source of infection in many febrile infants is challenging because of insufficient presentation of signs and symptoms. Meningitis is a critical cause of fever in infants, and its diagnosis is confirmed invasively by lumbar puncture. This study aimed to evaluate potential laboratory markers for meningitis in febrile infants. Methods: We retrospectively analyzed infants aged <3 months who visited the emergency department of our hospital between May 2012 and May 2017 because of fever of unknown etiology. Clinical information and laboratory data were evaluated. Receiver operating characteristic (ROC) curves were constructed. Results: In total, 145 febrile infants aged <3 months who underwent lumbar punctures were evaluated retrospectively. The mean C-reactive protein (CRP) level was significantly higher in the meningitis group than in the non-meningitis group, whereas the mean white blood cell count or absolute neutrophil count (ANC) did not significantly differ between groups. The area under the ROC curve (AUC) for CRP was 0.779 (95% confidence interval [CI], 0.701-0.858). The AUC for the leukocyte count was 0.455 (95% CI, 0.360-0.550) and that for ANC was 0.453 (95% CI, 0.359-0.547). The CRP cut-off value of 10 mg/L was optimal for identifying possible meningitis. Conclusion: CRP has an intrinsic predictive value for meningitis in febrile infants aged <3 months. Despite its invasiveness, a lumbar puncture may be recommended to diagnose meningitis in young, febrile infants with a CRP level >10 mg/L.

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“…Bakteriyel ve aseptik menenjit ayrımında serum prokalsitonin düzeyinin ≥ 0,5 ng/mL, > 2 ng/mL, > 4,8 ng/mL, ≥ 5 pg/mL düzeylerindeki kesim noktalarındaki duyarlılığı %100-89 ve özgüllüğü %93,5-66 arasında değiştiği rapor edilmiştir (13)(14)(15)(16)(17). Bu çalışmaların bir kısmında prokalsitoninin, CRP ve tam kan sayımı parametrelerine göre bakteriyel menenjiti öngörmede daha duyarlı bir laboratuvar testi olduğu bildirilmiştir (14)(15)(16)(17). Çalışmamızda lökosit sayısı açısından gruplar arasında hem rakamsal hem de istatistiksel olarak fark saptanmadı.…”

Section: Discussionunclassified

THE EFFECTIVENESS OF LABORATORY TESTS FOR THE PREDICTION OF ACUTE BACTERIAL MENINGITIS IN THE PEDİATRİC EMERGENCY DEPARTMENT The Effectiveness of Laboratory Tests for the Prediction of Acute Bacterial Menengitis in the Pediatric Emergency Department

Gökalp¹,

Bal²,

Bıcılıoğlu³

et al. 2015

Turk J Ped Em Int Care Med

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ÖZET Amaç:Çocuk acil servisinde akut bakteriyel menenjit ön tanısıyla lomber ponksiyon yapılan çocuklarda laboratuvar tetkiklerinin tanıdaki yerinin araştırılması. Yöntemler: 01.01.2008 -31.12.2013 yılları arasında İzmir Tepecik Eğitim ve Araştırma Hastanesi Çocuk Acil Servisi'nde akut bakteriyel menenjit ön tanısıyla lomber ponksiyon yapılan çocukların tıbbi kayıtları geriye dönük olarak incelenmiştir. Başvuru öncesi antibiyotik kullanan olgular çalışma dışı bırakılmıştır. Olgular 3 grup altında toplanmıştır: Normal beyin omurilik sıvısı (BOS), aseptik menenjit ve akut bakteriyel menenjit. Bu üç grubun laboratuvar tetkikleri karşılaştırılmıştır. Bulgular: Toplam 632 olgu (ortalama yaş: 42,2 ± 0,8 ay; minimum: 1 ay; maksimum: 210 ay; 387 erkek) çalışmaya dahil edildi. Toplam 205 olguda (%32,4) normal BOS bulguları, 401 olguda (%63,4) aseptik menenjit ve 29 olguda (%4,6) akut bakteriyel menenjit saptandı. Akut bakteriyel menenjit grubunda serum prokalsitonin düzeyi yüksek ve BOS glikoz düzeyi düşük saptandı (p < 0,05). Serum prokalsitoninin (< 24 ng/mL) ve BOS glikozunun (< 49 mg/dL) duyarlılık-ları %95 ve %51,8; özgüllükleri %92 ve %70,6 olarak saptandı. Periferik kandaki lökosit ve nötro l sayıları, serum Creaktif protein düzeyi, BOS lökosit sayısı ve protein düzeyleri açısından gruplar arasında fark saptanmadı (p > 0,05). Sonuç: Acil serviste lomber ponksiyon yapılan çocuk olguların çok az bir kısmında akut bakteriyel menenjit saptanmıştır. Serum prokalsitonin ölçümü çocuk acil servisinde akut bakteriyel menenjiti ayırt etmede etkin bir laboratuvar testi olarak öne çıkmıştır. CAYD 2015;2(1):19-24. Anah tar Ke li me ler: Menenjit, prokalsitonin, BOS glikoz, Çocuk AcilTo evaluate the accuracy of laboratory tests in identifying children who had lumbar puncture for suspected bacterial meningitis in the ED. Methods: Retrospective review of the medical records of children with preliminary diagnosis of acute bacterial meningitis and had a lumbar puncture between January 1st, 2008 and December 31st, 2013. All patients presenting to the emergency department (ED) of Izmir Training and Research hospital during the study period. Children who received antibiotics prior to admission to the ED were excluded. The patient population was strati ed into three group based on the results of cerebrospinal analysis and culture (CSF); normal, aseptic meningitis, and bacterial meningitis. The results of all laboratory tests were compared between the groups. Results: We enrolled 632 patients. The mean age was 42.2 ± 0.8 month (range 1-210 months) and 387 were males. Normal CSF was noted in 205 patients (32.4%), aseptic meningitis 401 patients (63.4%), and 29 (4.6%) had bacterial meningitis. Children with acute bacterial meningitis had a higher level of procalcitonin and lower levels of CSF glucose

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Serum Procalcitonin in Septic Meningitis

Abstract: Serum PCT may be used as diagnostic marker for septic meningitis and its differentiation from aseptic meningitis.

Cited by 28 publications

References 18 publications

Utility of Cerebrospinal Fluid and Serum Procalcitonin for the Diagnosis of Neonatal Meningitis

Utility of Cerebrospinal Fluid and Serum Procalcitonin for the Diagnosis of Neonatal Meningitis

Predictive value of C-reactive protein for the diagnosis of meningitis in febrile infants under 3 months of age in the emergency department

THE EFFECTIVENESS OF LABORATORY TESTS FOR THE PREDICTION OF ACUTE BACTERIAL MENINGITIS IN THE PEDİATRİC EMERGENCY DEPARTMENT The Effectiveness of Laboratory Tests for the Prediction of Acute Bacterial Menengitis in the Pediatric Emergency Department

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