[Procalcitonin, C-reactive protein and interleukin 6 in bacterial and viral meningitis in children]

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D Gendrel1, J Raymond, M Assicot

  • 1Hopital Saint Vincent-de-Paul, Paris.

Presse Medicale (Paris, France : 1983)
|October 13, 1998
PubMed
Abstract

Insights

Serum procalcitonin (PCT) effectively distinguishes bacterial meningitis from viral meningitis in children. This new marker aids early diagnosis, unlike traditional CSF analysis, improving treatment decisions for pediatric meningitis.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Diagnostics
  • Biomarker Research

Background:

  • Meningitis in children often requires empirical antibiotic treatment due to diagnostic challenges.
  • Current cerebrospinal fluid (CSF) and blood markers like C-reactive protein (CRP) and interleukin-6 (IL-6) show limited ability to differentiate viral meningitis (VM) from bacterial meningitis (BM).

Purpose of the Study:

  • To evaluate serum procalcitonin (PCT) as a diagnostic marker for differentiating VM from BM in pediatric patients.
  • To compare the efficacy of PCT with established markers such as CRP and IL-6.

Main Methods:

  • Serum PCT levels were measured using a chemiluminescent assay in 23 children with BM and 51 children with VM.
  • CSF analysis, including protein levels and white blood cell counts, was performed.
  • IL-6 levels were also assessed for comparison.

Main Results:

  • Traditional markers (CRP, CSF protein, WBC count) were insufficient to reliably distinguish BM from VM.
  • Interleukin-6 (IL-6) showed an overlap in values between VM and BM groups.
  • Serum PCT levels were highly discriminative, with significantly higher levels in BM (mean 61 µg/l) compared to VM (mean 0.33 µg/l; p < 0.001).
  • PCT was undetectable in CSF, and levels decreased with antibiotic treatment in BM patients.

Conclusions:

  • Serum procalcitonin (PCT) is a sensitive and specific biomarker for the early and accurate diagnosis of bacterial meningitis versus viral meningitis in children.
  • PCT offers a reliable method to guide antibiotic therapy decisions in pediatric meningitis cases.

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