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Serum procalcitonin in bacterial & non-bacterial meningitis in children

Shipra Chaudhary1, Nisha Keshary Bhatta2, Madhab Lamsal2

  • 1B P Koirala Institute of Health Sciences, Dharan, Nepal. nowshipra@gmail.com.

BMC Pediatrics
|November 4, 2018
PubMed

Insights

Serum procalcitonin (PCT) effectively differentiates bacterial meningitis from non-bacterial meningitis in children. This marker shows high sensitivity and specificity, aiding prompt diagnosis and improved patient management.

Area of Science:

  • Pediatric Infectious Diseases
  • Biomarker Research
  • Clinical Diagnostics

Background:

  • Bacterial meningitis is a critical pediatric emergency with significant mortality and morbidity.
  • Differentiating bacterial from non-bacterial meningitis clinically is challenging.
  • Elevated serum procalcitonin (PCT) is observed in bacterial infections, but clear diagnostic guidelines are lacking.

Purpose of the Study:

  • To evaluate serum procalcitonin (PCT) as a diagnostic marker for differentiating bacterial meningitis from non-bacterial meningitis in children.
  • To assess the efficacy of serum PCT in pediatric meningitis diagnosis.

Main Methods:

  • A cross-sectional study involving 50 children aged 3 months to 15 years with suspected meningitis.
  • Investigations included complete blood counts, cerebrospinal fluid (CSF) analysis, and serum PCT measurement.
  • Patients were classified into bacterial (22) and non-bacterial (28) meningitis groups based on clinical and CSF findings.

Main Results:

  • Serum PCT levels were significantly higher in bacterial meningitis (median 2.04 ng/ml) compared to non-bacterial meningitis (median 0.35 ng/ml) (p < 0.001).
  • At a cut-off of 0.5 ng/ml, serum PCT demonstrated 95.45% sensitivity and 84.61% specificity for bacterial meningitis.
  • Procalcitonin yielded the highest area under the ROC curve (0.991), outperforming total leukocyte count and CSF cytochemistry.

Conclusions:

  • Serum PCT is a highly sensitive and specific biomarker for the early diagnosis of bacterial meningitis in children.
  • Serum PCT serves as a valuable adjunct in distinguishing between bacterial and non-bacterial meningitis.
  • Utilizing serum PCT facilitates prompt and improved management of pediatric meningitis cases.
Abstract

Keywords:
Bacterial meningitisCerebrospinal fluidLeukocyte countProcalcitonin

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