Cerebrospinal fluid C-reactive protein in the diagnosis of meningitis in children
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Diagnosing bacterial meningitis in children can be improved with cerebrospinal fluid C-reactive protein testing. This method shows high accuracy, aiding in prompt identification and potentially reducing high mortality rates.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Diagnostics
Background:
- Bacterial meningitis in infants and children has a high mortality rate (40-50%).
- Accurate and prompt diagnosis is crucial for reducing mortality.
- Current diagnostic methods for meningitis present clinical challenges.
Purpose of the Study:
- To evaluate the diagnostic utility of cerebrospinal fluid C-reactive protein (CSF-CRP) for bacterial meningitis in pediatric patients.
- To compare the sensitivity and specificity of CSF-CRP with other standard meningitis diagnostic markers.
Main Methods:
- A qualitative latex agglutination slide test was used to examine CSF-CRP levels.
- The study included 44 pediatric patients with clinical meningitis.
- CSF-CRP results were analyzed against bacterial and non-bacterial meningitis diagnoses.
Main Results:
- CSF-CRP was positive in 90% of bacterial meningitis cases (18/20) and 8.3% of non-bacterial meningitis cases (2/24).
- CSF-CRP demonstrated high sensitivity (90%) and specificity (91.7%).
- CSF-CRP outperformed traditional markers like white cell count, polymorphonuclear count, glucose, protein levels, and CSF smear in diagnostic accuracy.
Conclusions:
- Cerebrospinal fluid C-reactive protein testing is a valuable diagnostic tool for bacterial meningitis in children.
- CSF-CRP offers superior sensitivity and specificity compared to conventional diagnostic methods.
- Implementing CSF-CRP testing can facilitate earlier and more accurate diagnosis, potentially improving patient outcomes.
Abstract:
The mortality rate of bacterial meningitis in infants and children is still high (40-50%). Such a mortality rate can be reduced by establishing a prompt and accurate diagnosis. Until now the diagnosis of meningitis is still an important clinical problem. The examination of cerebrospinal fluid C-reactive protein had been done in 44 clinical meningitis patients in the Paediatrics Department, Dr. Sardjito General Hospital qualitatively by means of latex agglutination slide test. Cerebrospinal fluid C-reactive protein was positive in 90% (18/20) of bacterial meningitis patients compared to 8.3% (2/24) of non bacterial meningitis patients. The sensitivity and specificity of cerebrospinal fluid C-reactive protein were 90% and 91.7% respectively and these values were more sensitive and specific than those of white cell count, absolute polymorphonuclear, glucose and protein levels and the cerebrospinal fluid smear (50-80% and 80-91% respectively) which had been performed in the diagnosis of meningitis. It can be concluded that the examination of cerebrospinal fluid C-reactive protein can be used as a diagnostic tool of bacterial meningitis.