Is Cerebrospinal Fluid C-reactive Protein a Better Tool than Blood C-reactive Protein in Laboratory Diagnosis of Meningitis in Children?
Journal Title: Sultan Qaboos University Medical Journal - Year 2013, Vol 13, Issue 1
Abstract
Objectives: Tis study aimed to test whether C-reactive protein (CRP) measurement could differentiate between different types of meningitis and become a routine test. Methods: A prospective study included 140 children admitted to Manipal Teaching Hospital, Pokhara, Nepal, between July 2009 and June 2011. Te subjects had a blood test and detailed cerebrospinal fluid (CSF) analysis, including blood and CSF CRP levels. Results: Of those admitted, 31.1% had pyogenic meningitis (PM), 26.2% partially treated meningitis (PPM), 33% viral meningitis (VM), and 9.7% tubercular meningitis (TBM), with 26.4% controls. Organisms were isolated in 12.5% of the cases by blood culture and 25% of cases through CSF culture. Blood CRP was positive in all groups, with the highest values in PM (53.12 ± 28.88 mg/dl) and PPM (47.55 ± 34.34 mg/dl); this was not statistically signifcant (P = 0.08). Te CSF CRP levels were signifcantly higher (P <0.001) in PM (45.75 ± 28.50 mg/dl) and PPM (23.11 ± 23.98 mg/dl). Te sensitivity and specifcity of blood CRP was 90.62%, 88.88%, 64.7%, 70% and 32.4%, 30.97%, 24.52%, 26.12% and that of CSF CRP was 96.87%, 66.66%, 20.58%, 10% and 74.73%, 63.71%, 50.94%, 55.35% for PM, PPM, VM and TBM, respectively. Conclusion: Because of its high sensitivity, both CSF CRP and blood CRP can be used to screen for bacterial meningitis (both PM and PPM). CSF CRP screening yielded results with a higher specifcity than blood CRP; hence, it can be a supportive test along with CSF cytology, biochemistry, and microbiology for diagnosing meningitis.
Authors and Affiliations
Kalpana K. Malla| Departments of 1Pediatrics, Manipal College of Medical Sciences, Pokhara, Nepal, Tejesh Malla| Departments of 1Pediatrics, Manipal College of Medical Sciences, Pokhara, Nepal, K. Seshagiri Rao| Departments of 1Pediatrics, Manipal College of Medical Sciences, Pokhara, Nepal, Sahisnuta Basnet| Departments of 1Pediatrics, Manipal College of Medical Sciences, Pokhara, Nepal, Ravi Shah| Departments of 1Pediatrics, Manipal College of Medical Sciences, Pokhara, Nepal
Keywords
Related Articles
- EP ID EP14312
- DOI -
- Views 325
- Downloads 8
Sociodemographic and Clinical Characteristics of Patients attending Psychotherapy in a Tertiary Care Hospital in Oman
Tere is signifcant evidence that psychotherapy is a pivotal treatment for persons diagnosed with Axis I clinical psychiatric conditions; however, a psychotherapy service has only recently been established in the Omani...
Gallium-67 Scintigraphy in the Era of Positron Emission Tomography and Computed Tomography Tertiary centre experience
Objectives: Although 18F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) has largely replaced the use of gallium-67 (67Ga) scintigraphy in the evaluation and follow-up of lymphoma patien...
Bilateral Ocular Ischaemic Syndrome—Rare Complication of Rhinocerebral Mucormycosis in an Omani Patient Case report and literature review
Ocular ischaemic syndrome (OIS) is a relatively uncommon condition. Simultaneous bilateral involvement is even less common and has been reported in only 22% of all cases of OIS. It has variable clinical presentations,...
Te Preclinical-Clinical Divide: Building Bridges
Sleepy Drivers: High time for action
No Abstract