Journal of Clinical and Diagnostic Research (Aug 2018)
Role of CSF C-Reactive Protein for Rapid Diagnosis and Differentiation of Different Forms of Meningitis in Children
Abstract
Introduction: Timely diagnosis and prompt initiation of therapy in pyogenic meningitis decreases morbidity and mortality. Measurement of Cerebrospinal Fluid (CSF) C-Reactive Protein (CRP) may help in the early diagnosis of pyogenic meningitis. Aim: To evaluate the usefulness of CSF CRP (by immunoturbidimetric method) in the rapid diagnosis of pyogenic (acute and partially treated meningitis) and to differentiate the same from other forms of meningitis. Materials and Methods: This cross-sectional study was conducted in the department of Paediatrics of a tertiary care teaching hospital from November 2013 to October 2015. CRP in the CSF of suspected meningitis cases was measured by using the immunoturbidimetric method. All data were analysed by using appropriate software (SPSS 24/Microsoft Excel 2016). ANOVA was used for analysis. ROC curves were constructed, and diagnostic odds ratios were calculated. Results: Of 198 cases, 31 were acute bacterial meningitis, 61 were partially treated meningitis, 10 were tubercular, 57 were aseptic, and 39 were without meningitis. A statistically significant difference in the CSF CRP level (mg/dL) between groups was found {F (4,193)=59. 470, p<0.001}. Sensitivity and specificity of CSF CRP for acute bacterial meningitis was 87.1% and 94.87%, respectively; and for partially treated meningitis was 88.52% and 94.84%, respectively. The cut-off value of CSF CRP for both acute bacterial and partially treated meningitis was evaluated as ≥0.62 mg/dL and ≥0.55 mg/dL, respectively. Conclusion: CSF CRP measurement seems to be a valid early diagnostic test for pyogenic meningitis. It also helps in differentiating pyogenic from other forms of meningitis. The cut off value of CSF CRP for both acute bacterial and partially treated meningitis was ≥0.62 mg/dL and ≥0.55 mg/dL, respectively.
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