Role of CSF C-Reactive Protein for the Differentiation of Bacterial Meningitis from Aseptic Meningitis in Children

Khanam, Rafeza; Hanif, Mohammad; Hoque, Mahbubul; Tawfique, Muhammad; Ahmed, Asm Nawshad Uddin

doi:10.3329/bjch.v36i3.14275

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…18 Khanam R et al in their study reported Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) to be 35%, 100%, 100% and 53.6% respectively. 17 CRP migration to CSF is not properly explained in literature. CSF-CRP levels were fund to be lower than that of serum CRP.…”

Section: Discussionmentioning

confidence: 99%

“…16 However, Khanam R had reported only 35% of bacterial meningitis cases to be CSF-CRP positive. 17 Our study reported the CSF-CRP to have a Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and Diagnostic Accuracy (DA) of 72.92%, 85.71%, 85.71%, 73.47% and 78.89% respectively. Singh N et al in their study concluded that CSF-CRP had a sensitivity of 84%, specificity of 100% and a positive predictive value of 100%.…”

Section: Discussionmentioning

confidence: 99%

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Study of CSF C-reactive protein in meningitis to differentiate bacterial meningitis from aseptic meningitis in children between 1 month and 12 years of age

Natani

Goyal

Agarwal

et al. 2017

Int J Contemp Pediatr

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Background: Meningitis is a serious illness of childhood. CSF Gram stain and culture is the gold standard for diagnosis which is a costly and time consuming. So, this study was conducted with the objective to measure the specificity, sensitivity, positive and negative predictive values and diagnostic accuracy of CSF-CRP in the diagnosis of bacterial meningitis.Methods: This prospective study was conducted in Department of Pediatrics, National Institute of Medical Sciences and Research, Jaipur. Children between 1 month to 12 years of age admitted with acute history of fever and seizure were included. CSF was sent for CRP estimation and other laboratory investigations. CSF CRP was determined qualitatively and value >6mcg/ml was considered positive. Patients were divided into three groups based on clinical and CSF findings. Group 1 (Bacterial meningitis), Group 2 (Aseptic Meningitis) and Group 3 (No meningitis/Control Group). Statistical analysis was done using software SPSS version 23.Results: 120 patients were enrolled in our study. 65% of our cases were males. The mean age of our cases was 74.9±39.8 months. 48 cases had bacterial meningitis, 42 cases had Aseptic Meningitis and 30 cases had no meningitis. CSF-CRP was positive in 35 cases of Bacterial meningitis, 6 cases of aseptic meningitis and negative in all cases of control group. Hence the Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Diagnostic Accuracy of CSF-CRP for diagnosis of bacterial meningitis were 72.92%, 85.71%, 85.71%, 73.47% and 78.89% respectively. CSF-CRP cases of bacterial meningitis were also found to have a poor outcome.Conclusions:CSF-CRP can be used as an initial test for the diagnosis of Bacterial Meningitis till other confirmatory test reports are awaited.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Study of CSF C-reactive protein in meningitis to differentiate bacterial meningitis from aseptic meningitis in children between 1 month and 12 years of age

Natani

Goyal

Agarwal

et al. 2017

Int J Contemp Pediatr

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Cerebrospinal Fluid (CSF) Presepsin as a Diagnostic Marker for Bacterial Meningitis in Pediatric Intensive Care Units

Attia

Ibrahem

Mohamed

et al. 2020

The Egyptian Journal of Hospital Medicine

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Comparing CSF Parameters Between Children Diagnosed With Bacterialand Aseptic Meningitis

Sah¹,

Manandhar

Pareek

et al. 2021

ijsr

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Introduction: Diagnosis of meningitis in children cannot rely on clinical examination. Present study aimed to evaluate the role of CSF examination in differentiating bacterial from aseptic meningitis in children less than 14 years of age. Methodology: This observational crosssectional study included children aged 1 month to 14 years with a diagnosis of meningitis. Children were classied as bacterial meningitis or aseptic meningitis. CSF examination was conducted to measure CRP, cell count, neutrophil count, lymphocytes, glucose levels and protein levels. Statistical comparison was made between children with bacterial meningitis and aseptic meningitis. Results: Children aged less than 2 years had the highest incidence of meningitis to the extent of 30.6%. CSF examination revealed than CRP was found to be positive in 81.82% of the patients with bacterial meningitis, while only 3.45% of the patients with aseptic meningitis had a positive CRP (p value < 0.001). It was observed that median cell count and neutrophil count were signicantly higher among patients with bacterial meningitis as compared to those with aseptic meningitis. While, median lymphocyte count was signicantly lower in patients with bacterial meningitis as compared to those with aseptic meningitis (p value < 0.001). Furthermore, we observed that CSF glucose less than 50% of that blood levels was observed in 81.82% of the patients with bacterial meningitis, which was signicantly higher than those diagnosed with aseptic meningitis (p value < 0.05). Conclusions: CSF CRP and biochemical parameters like cell count, neutrophils and glucose levels can aid in differentiating bacterial from aseptic meningitis

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Role of CSF C-Reactive Protein for the Differentiation of Bacterial Meningitis from Aseptic Meningitis in Children

Abstract: Summary

Cited by 4 publications

References 24 publications

Study of CSF C-reactive protein in meningitis to differentiate bacterial meningitis from aseptic meningitis in children between 1 month and 12 years of age

Study of CSF C-reactive protein in meningitis to differentiate bacterial meningitis from aseptic meningitis in children between 1 month and 12 years of age

Cerebrospinal Fluid (CSF) Presepsin as a Diagnostic Marker for Bacterial Meningitis in Pediatric Intensive Care Units

Comparing CSF Parameters Between Children Diagnosed With Bacterialand Aseptic Meningitis

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