Serum procalcitonin in pediatric bacterial meningitis versus pediatric non bacterial meningitis: open label prospective study
Keywords:Bacterial Meningitis, CSF Glucose, CSF Protein, Non Bacterial Meningitis, Procalcitonin
Background: Several studies have shown potential value of serum Procalcitonin level (SPCT) for diagnosing and differentiating bacterial meningitis (BME) from other, but the results were inconsistent.
Methods: Children from birth to 12 years, with clinical suspicion of meningitis were enrolled. Clinical and laboratory information was collected and cases were classified according to pre decided case definition (based on clinical and laboratory) as bacterial or non-bacterial meningitis (NBME).
Results: Out of 4393 admission (2016-17) 60 patients were selected for final study (on basis of case definition) which were equally distributed in both group (BME and NBME) in terms of age and sex (p 0.97). 29/41 (70%) patients of pyogenic meningitis had high level of SPCT which was significant, whereas only 2/19 (10.5%) patients of NBME had high level of SPCT. Although SPCT seems to be the good marker in differentiating between BME and NBME, SPCT level specificity (89%) in the diagnosis of BME was not higher than CSF protein level (94%) and CSF glucose level (94%).
Conclusions: Measurement of plasma SPCT levels are of value in differentiating BME & NBME in children. However, SPCT should not be used as single sole diagnostic marker of BME if CSF protein and glucose are available. CSF WBC Count alone should not to be used in diagnosis of BME as specificity is low. This study needs to be validated with a larger sample size and microbiological confirmation of bacterial disease.
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