The value of serum procalcitonin in acute meningitis in children

shorbagy, Hatem H. El; Barseem, Naglaa Fathy; Abdelghani, Waleed Elsayed; Suliman, Hany Abdelaziz; Al-Shokary, Ashraf Hamed; Elsadek, Akram Elshafey; Maksoud, Yehia Hamed Abdel; Sabri, Jehan H.

doi:10.1016/j.jocn.2018.08.012

Cited by 10 publications

(15 citation statements)

References 23 publications

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“…One study showed that a procalcitonin level >0.5 ng/mL was 99% sensitive and 83% specific for ABM, 47 while another study showing a value of >2 ng/mL was 100% sensitive and 63% specific. 48 This latter study also showed that the procalcitonin level could also be used to follow the response to antibiotic therapy.…”

Section: Inflammatory Markers and Biomarkermentioning

confidence: 92%

“…Normal C-reactive protein (CRP) and procalcitonin values have good diagnostic accuracy in excluding all bacterial infections including those causing meningitis but they are not widely used in clinical practice. [46][47][48] Serum concentration of CRP greater than 80 mg/dl 41 and elevated serum procalcitonin level (0.5-ng/mL) can be helpful in identifying patients with ABM. One study showed that a procalcitonin level >0.5 ng/mL was 99% sensitive and 83% specific for ABM, 47 while another study showing a value of >2 ng/mL was 100% sensitive and 63% specific.…”

Section: Inflammatory Markers and Biomarkermentioning

confidence: 99%

“…In neonates, mortality rates ranges from 10% in developed countries to 58% in developing countries. 46,48 In a recent prospective study for infants <90 days from the United Kingdom and Ireland, mortality rate was 9%, with 23% rate of serious central nervous system complications in the form (seizures, motor disorder, hydrocephalus with or without a ventriculoperitoneal shunt, hearing loss or extradural collection requiring neurosurgical intervention) in the survivors. 41 In this study, mortality was associated with prematurity, coma on admission and S. pneumoniae as a causative agent, while the risk of serious CNS complications was associated with temperature instability, seizures, elevated CSF protein and S. pneumoniae as the causative agent.…”

Section: Outcomementioning

confidence: 99%

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<p>Management of Acute Bacterial Meningitis in Children</p>

Alamarat¹,

Hasbun²

2020

IDR

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Acute community-acquired bacterial meningitis (ABM) in children continues to have high rates of neurological morbidity and mortality despite the overall declining rates of infection attributed to the use of vaccines and intrapartum Group B Streptococcus prophylaxis. Prompt diagnosis and early antibiotic therapy are crucial and should not be delayed to obtain cranial imaging. Differentiating bacterial from viral meningitis continues to be a clinical dilemma especially in patients with previous antibiotic exposure. Clinical models and inflammatory biomarkers can aid clinicians in their diagnostic approach. Multiplex polymerase chain reaction and metagenomic next-generation sequencing are promising tools that can help in early and accurate diagnosis. This review will present the epidemiology of ABM in children, indications of cranial imaging, role of different models and serum biomarkers in diagnosing ABM, and management including the use of adjunctive therapies and methods of prevention.

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Section: Inflammatory Markers and Biomarkermentioning

confidence: 92%

Section: Inflammatory Markers and Biomarkermentioning

confidence: 99%

Section: Outcomementioning

confidence: 99%

See 1 more Smart Citation

<p>Management of Acute Bacterial Meningitis in Children</p>

Alamarat¹,

Hasbun²

2020

IDR

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“…In contrast to bacterial infections, viral infections usually induce modest PCT production because interferon-γ inhibits adipocytes from producing PCT [ 4 ]. Consequently, it is said that the PCT value can help to distinguish bacterial from viral meningitis [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Serum Procalcitonin in Patients with Convulsion in Emergency Department, an Observational Study

et al. 2020

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Procalcitonin (PCT), a widely used biomarker for bacterial infections, is sometimes measured in convulsion patients to distinguish bacterial infections including bacterial meningitis. However, serum PCT elevation is reported in several other conditions. This study assessed the diagnostic value of serum PCT concentrations in convulsion patients. This study examined a convulsion group: patients admitted to our critical care center during April 2018 through September 2019 via the emergency department presenting with convulsions. Randomly sampled patients admitted without convulsions were categorized as a non-convulsion group. Serum PCT analysis was performed with consideration of whether or not the patient had an infection. Diagnostic values of serum PCT for bacterial infection were evaluated for convulsion and non-convulsion patients using the positive likelihood ratio of PCT. This study found 84 patients as eligible for the convulsion group; 1:2 matched 168 control patients were selected as non-convulsion group members. The positive likelihood ratio for bacterial infection was found to be significantly lower in the convulsion group than in the control group (1.94 vs. 2.65) when setting the positive cut-off for PCT as 0.5 ng/mL. Convulsion patients had a higher PCT value. The positive likelihood ratio for patients without bacterial infection was lower.

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“…The remaining 14 articles were eligible for data extraction, of which four articles reported two different sets of data using different cutoff values; thus, they were regarded as two separate studies. Finally, 18 studies comprising 1462 samples [ 10 , 16 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ] were included ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Blood Procalcitonin Level as a Diagnostic Marker of Pediatric Bacterial Meningitis: A Systematic Review and Meta-Analysis

2021

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Early diagnosis and treatment of bacterial meningitis in children are essential, due to the high mortality and morbidity rates. However, lumbar puncture is often difficult, and cerebrospinal fluid (CSF) culture takes time. This meta-analysis aims to determine the diagnostic accuracy of blood procalcitonin for detecting bacterial meningitis in children. We conducted a systematic search on electronic databases to identify relevant studies. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated, and a hierarchical summary receiver operating characteristic curve and area under the curve (AUC) were determined. Eighteen studies with 1462 children were included in the analysis. The pooled sensitivity, specificity, and the DOR of blood procalcitonin for detecting bacterial meningitis were 0.87 (95% confidence interval (CI): 0.78–0.93); 0.85 (95% CI: 0.75–0.91), and 35.85 (95% CI: 10.68–120.28), respectively. The AUC for blood procalcitonin was 0.921. Blood procalcitonin also showed higher diagnostic accuracy for detecting bacterial meningitis than other conventional biomarkers, including serum C-reactive protein and leukocyte count, CSF leukocyte and neutrophil count, and CSF protein and glucose levels. Blood procalcitonin can be a good supplemental biomarker with high diagnostic accuracy in detecting bacterial meningitis in children.

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The value of serum procalcitonin in acute meningitis in children

Cited by 10 publications

References 23 publications

<p>Management of Acute Bacterial Meningitis in Children</p>

<p>Management of Acute Bacterial Meningitis in Children</p>

Diagnostic Value of Serum Procalcitonin in Patients with Convulsion in Emergency Department, an Observational Study

Blood Procalcitonin Level as a Diagnostic Marker of Pediatric Bacterial Meningitis: A Systematic Review and Meta-Analysis

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