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The use of C-reactive protein from cerebrospinal fluid for differentiating meningitis from other central nervous
Abstract:
C-reactive protein (C-RP) determinations were performed by using the latex slide agglutination test on cerebrospinal fluid (CSF) from 235 patients. The patients were categorized into the following groups: bacterial meningitis (n = 74); viral meningitis (n = 10); fever without bacterial meningitis (n = 80); neurological symptoms without infection (n = 25); intracranial hemorrhage (n = 10); increased intracranial pressure that was secondary to pseudotumor cerebri or hydrocephalus (n = 16); and malignancies (n = 20). On the initial lumbar puncture, the C-RP was positive in 97% (72 of 74) of the patients in group 1, as compared with 0% (0 of 10), 6% (5 of 80), 20% (5 of 25), 50% (5 of 10), 6% (1 of 16), and 30% (6 of 20) in groups 2-7, respectively (P less than .0001). The C-RP test was able to detect bacterial meningitis with a sensitivity of 97% (72 of 74), a specificity of 86% (139 of 161), a positive predictive value of 77% (72 of 94), and a negative predictive value of 99% (139 of 141). These data indicate that C-RP determinations performed on CSF are useful and rapid clinical tests for the exclusion of the presence of bacterial meningitis in a patient.
Insights
C-reactive protein (CRP) testing on cerebrospinal fluid (CSF) is a highly sensitive and specific tool for diagnosing bacterial meningitis. This rapid test can effectively rule out bacterial meningitis in patients presenting with neurological symptoms.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Chemistry
Background:
- Bacterial meningitis is a serious infection requiring prompt diagnosis and treatment.
- Cerebrospinal fluid (CSF) analysis is crucial for diagnosing meningitis.
- C-reactive protein (CRP) is an inflammatory marker that may aid in diagnosis.
Purpose of the Study:
- To evaluate the utility of C-reactive protein (CRP) testing on CSF for diagnosing bacterial meningitis.
- To determine the sensitivity, specificity, and predictive values of CSF CRP in differentiating bacterial meningitis from other neurological conditions.
Main Methods:
- Latex slide agglutination test for C-reactive protein (CRP) performed on CSF samples.
- Analysis of 235 patient CSF samples categorized into bacterial meningitis and various control groups.
- Statistical evaluation of diagnostic accuracy, including sensitivity, specificity, and predictive values.
Main Results:
- CSF CRP was positive in 97% of bacterial meningitis cases.
- CSF CRP showed significantly higher positivity in bacterial meningitis compared to viral meningitis, fever without meningitis, and other neurological conditions (P < .0001).
- The test demonstrated high sensitivity (97%), specificity (86%), positive predictive value (77%), and negative predictive value (99%) for bacterial meningitis.
Conclusions:
- CSF C-reactive protein (CRP) determination is a valuable and rapid diagnostic tool.
- The test is highly effective in excluding bacterial meningitis when results are negative.
- CSF CRP testing can aid clinicians in the timely management of patients with suspected meningitis.