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Serum Procalcitonin in Viral and Bacterial Meningitis

BACKGROUND: In children with meningitis, there is a difficulty to verify the etiology as viral or bacterial. Therefore, intensive research has been carried out to find new and rapid diagnostic methods for differentiating bacterial from viral meningitis. OBJECTIVES: The aim of this work was to study...

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Autores principales: Alkholi, Usama M, Abd Al-monem, Nermin, Abd El-Azim, Ayman A, Sultan, Mohamed H
Formato: Texto
Lenguaje:English
Publicado: Medknow Publications 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068572/
https://www.ncbi.nlm.nih.gov/pubmed/21572603
http://dx.doi.org/10.4103/0974-777X.77290
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author Alkholi, Usama M
Abd Al-monem, Nermin
Abd El-Azim, Ayman A
Sultan, Mohamed H
author_facet Alkholi, Usama M
Abd Al-monem, Nermin
Abd El-Azim, Ayman A
Sultan, Mohamed H
author_sort Alkholi, Usama M
collection PubMed
description BACKGROUND: In children with meningitis, there is a difficulty to verify the etiology as viral or bacterial. Therefore, intensive research has been carried out to find new and rapid diagnostic methods for differentiating bacterial from viral meningitis. OBJECTIVES: The aim of this work was to study the behavior of procalcitonin (PCT) and whether it can be used to differentiate children with bacterial from those with viral meningitis. We also compared PCT to C-reactive protein (CRP) and white blood cell count. PATIENTS AND METHODS: Forty children aged from 4 months to 12 years with clinically suspected meningitis were studied. Lumbar punctures were done for all cases before starting initial antibiotic treatment. According to the results of bacterial cultures and cerebrospinal fluid (CSF) cytochemical profile, our patients were classified into two groups: bacterial meningitis group and viral meningitis group. PCT, CRP, and leukocyte count were measured at the time of admission and after 3 days. METHODS: Forty children aged from 4 months to 12 years with clinically suspected meningitis were studied. Lumbar punctures were done for all cases before starting initial antibiotic treatment. According to the results of bacterial cultures and cerebrospinal fluid (CSF) cytochemical profile, our patients were classified into two groups: bacterial meningitis group and viral meningitis group. PCT, CRP, and leukocyte count were measured at the time of admission and after 3 days. RESULTS: PCT levels were significantly higher in patients with bacterial meningitis (mean, 24.8 ng/ml) compared to patients with viral meningitis (mean, 0.3 ng/ml) (P<0.001). PCT levels in bacterial meningitis group decreased after 3 days of starting treatment, but remained higher than viral meningitis group (mean, 10.5 ng/ml). All CSF parameters, blood leukocytes, and CRP showed overlapping values between the two groups. Serum PCT with cut off value >2 ng/ml showed sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 66%, 68%, and 100%, respectively, for the diagnosis of bacterial meningitis. CONCLUSION: Serum procalcitonin level has a better diagnostic and prognostic value than CRP or leukocyte count to distinguish between bacterial and viral meningitis. It is also a good indicator of the efficacy of treatment of bacterial meningitis.
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spelling pubmed-30685722011-05-13 Serum Procalcitonin in Viral and Bacterial Meningitis Alkholi, Usama M Abd Al-monem, Nermin Abd El-Azim, Ayman A Sultan, Mohamed H J Glob Infect Dis Original Article BACKGROUND: In children with meningitis, there is a difficulty to verify the etiology as viral or bacterial. Therefore, intensive research has been carried out to find new and rapid diagnostic methods for differentiating bacterial from viral meningitis. OBJECTIVES: The aim of this work was to study the behavior of procalcitonin (PCT) and whether it can be used to differentiate children with bacterial from those with viral meningitis. We also compared PCT to C-reactive protein (CRP) and white blood cell count. PATIENTS AND METHODS: Forty children aged from 4 months to 12 years with clinically suspected meningitis were studied. Lumbar punctures were done for all cases before starting initial antibiotic treatment. According to the results of bacterial cultures and cerebrospinal fluid (CSF) cytochemical profile, our patients were classified into two groups: bacterial meningitis group and viral meningitis group. PCT, CRP, and leukocyte count were measured at the time of admission and after 3 days. METHODS: Forty children aged from 4 months to 12 years with clinically suspected meningitis were studied. Lumbar punctures were done for all cases before starting initial antibiotic treatment. According to the results of bacterial cultures and cerebrospinal fluid (CSF) cytochemical profile, our patients were classified into two groups: bacterial meningitis group and viral meningitis group. PCT, CRP, and leukocyte count were measured at the time of admission and after 3 days. RESULTS: PCT levels were significantly higher in patients with bacterial meningitis (mean, 24.8 ng/ml) compared to patients with viral meningitis (mean, 0.3 ng/ml) (P<0.001). PCT levels in bacterial meningitis group decreased after 3 days of starting treatment, but remained higher than viral meningitis group (mean, 10.5 ng/ml). All CSF parameters, blood leukocytes, and CRP showed overlapping values between the two groups. Serum PCT with cut off value >2 ng/ml showed sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 66%, 68%, and 100%, respectively, for the diagnosis of bacterial meningitis. CONCLUSION: Serum procalcitonin level has a better diagnostic and prognostic value than CRP or leukocyte count to distinguish between bacterial and viral meningitis. It is also a good indicator of the efficacy of treatment of bacterial meningitis. Medknow Publications 2011 /pmc/articles/PMC3068572/ /pubmed/21572603 http://dx.doi.org/10.4103/0974-777X.77290 Text en Copyright: © Journal of Global Infectious Diseases http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Alkholi, Usama M
Abd Al-monem, Nermin
Abd El-Azim, Ayman A
Sultan, Mohamed H
Serum Procalcitonin in Viral and Bacterial Meningitis
title Serum Procalcitonin in Viral and Bacterial Meningitis
title_full Serum Procalcitonin in Viral and Bacterial Meningitis
title_fullStr Serum Procalcitonin in Viral and Bacterial Meningitis
title_full_unstemmed Serum Procalcitonin in Viral and Bacterial Meningitis
title_short Serum Procalcitonin in Viral and Bacterial Meningitis
title_sort serum procalcitonin in viral and bacterial meningitis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068572/
https://www.ncbi.nlm.nih.gov/pubmed/21572603
http://dx.doi.org/10.4103/0974-777X.77290
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