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Mean platelet volume in the differential diagnosis of tuberculous and bacterial meningitis
Carlos Rodrigo Camara-Lemarroy1, Guillermo Delgado-Garcia, Juan Gilberto De la Cruz-Gonzalez
1University Hospital "Dr. Jose E. González", Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico. crcamara83@hotmail.com.
Introduction:
Mean platelet volume (MPV) has been shown to reflect the inflammatory burden in different inflammatory and autoimmune diseases. Our objective was to analyze the MPV in patients with tuberculous (TBM) and bacterial meningitis (BM).
Methodology:
The demographic and clinical data of 73 consecutive patients that presented with either BM (n = 35) or TBM (n = 38) were retrospectively analyzed, as well as that of 28 age- and sex-matched controls.
Results:
MPV was 8.78±1.58 fL in patients with BM and 6.42±1.39 fL in the TBM group (p < 0.05). In the control group, MPV was 7.4±0.66 fL, significantly higher and lower when compared with TBM and BM, respectively. MPV was significantly associated with diagnosis (adjusted OR: 5.15, 95% CI: 1.090-23.7; p = 0.03). With the optimal cut-off value of 7.62 fL, MPV had 82% sensibility and 78% specificity for the differential diagnosis of TBM versus BM. Lower platelet counts, higher serum creatinine, higher white blood cell counts, and higher blood-cerebrospinal fluid glucose ratio were also predictive of BM.
Conclusions:
Platelet counts were lower and MPV was higher in patients with BM compared to patients with TBM. Platelet indices, available in routine bloodwork, could be useful in the early differential diagnosis of these entities.
Insights
Mean platelet volume (MPV) can help differentiate bacterial meningitis (BM) from tuberculous meningitis (TBM). Higher MPV levels were observed in BM patients, suggesting its utility in early diagnosis.
Area of Science:
- Neurology
- Infectious Diseases
- Hematology
Background:
- Mean platelet volume (MPV) is an indicator of inflammatory burden in various diseases.
- Its role in differentiating types of meningitis requires further investigation.
Purpose of the Study:
- To analyze Mean platelet volume (MPV) in patients diagnosed with tuberculous meningitis (TBM) and bacterial meningitis (BM).
Main Methods:
- Retrospective analysis of demographic and clinical data from 73 patients with BM or TBM.
- Comparison of MPV values between patient groups and 28 healthy controls.
Main Results:
- MPV was significantly higher in BM patients (8.78±1.58 fL) compared to TBM patients (6.42±1.39 fL).
- An MPV cut-off of 7.62 fL showed 82% sensitivity and 78% specificity for differentiating TBM from BM.
- Lower platelet counts and higher white blood cell counts predicted BM.
Conclusions:
- MPV is a potential biomarker for distinguishing between BM and TBM.
- Platelet indices, routinely available, may aid in the early differential diagnosis of meningitis.
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