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Serum procalcitonin in septic meningitis
Rajniti Prasad1, Rishi Kapoor, Om Prakash Mishra
1Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Insights
Serum procalcitonin (PCT) is a valuable diagnostic marker for identifying septic meningitis in children. Elevated PCT levels effectively differentiate septic meningitis from aseptic meningitis, aiding in timely diagnosis and treatment.
Area of Science:
- Pediatric infectious diseases
- Biomarker research
- Clinical diagnostics
Background:
- Septic meningitis is a serious infection requiring rapid diagnosis.
- Differentiating septic from aseptic meningitis is crucial for appropriate treatment.
- Biomarkers can aid in the diagnostic process.
Purpose of the Study:
- To assess the utility of serum procalcitonin (PCT) in diagnosing pediatric septic meningitis.
- To evaluate PCT's effectiveness in distinguishing septic meningitis from aseptic meningitis.
Main Methods:
- The study involved 40 children diagnosed with septic meningitis and 15 with aseptic meningitis, plus 15 healthy controls.
- Serum PCT levels were measured using an ELISA kit.
- Diagnostic criteria included clinical presentation, CSF analysis, Gram's stain, and bacterial culture.
Main Results:
- Serum PCT levels were significantly higher in children with septic meningitis compared to aseptic meningitis and controls (p < 0.001).
- PCT demonstrated high sensitivity (98.5%) and specificity (93.5%) at a cutoff of ≥ 5,000 pg/mL for diagnosing septic meningitis.
- At a cutoff of 15,000 pg/mL, PCT showed 92% sensitivity and 67% specificity for differentiating septic from aseptic meningitis.
Conclusions:
- Serum procalcitonin serves as a reliable diagnostic marker for septic meningitis in children.
- PCT is effective in differentiating septic meningitis from aseptic meningitis, supporting its clinical application.
Objective:
To evaluate the role of serum procalcitonin (PCT) in diagnosis of septic meningitis in children and its efficacy in differential diagnosis.
Methods:
The study included 40 children of septic meningitis admitted in pediatric ward with fever, headache, vomiting and seizure, up to 14 y of age. The diagnosis of septic meningitis was based on clinical features; physical examination, blood and cerebrospinal fluid (CSF) cytochemical findings, gram's stain and bacterial culture. Fifteen cases of aseptic meningitis admitted during same period were also included in the study, and 15 children with normal CSF were taken as control. Serum PCT was measured by ELISA Kit.
Results:
Serum PCT level was significantly higher in children with septic meningitis than those with aseptic meningitis or in controls (p < 0.001). In culture and gram's stain positive 7 cases, serum procalcitonin was significantly elevated (24,768.21 ± 6,567.45 pg/mL) than aseptic meningitis(14,451.24 ± 4,266.15 pg/mL) (p < 0.001). Further its level was found significantly elevated in partially treated septic meningitis as compared to aseptic meningitis cases (p < 0.001). At optimum cut off value of ≥ 5,000 pg/mL, based on area under ROC curve, PCT showed sensitivity, specificity, positive predictive value and negative predictive value of 98.5 %, 93.5 %, 98.6 % and 93.3 % respectively. Serum PCT with cut off level of 15,000 pg/ml showed sensitivity, specificity, PPV and NPV of 92 %, 67 %, 91.4 % and 71.4 % respectively for the differentiation of septic from aseptic meningitis.
Conclusions:
Serum PCT may be used as diagnostic marker for septic meningitis and its differentiation from aseptic meningitis.
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