Role of Inflammatory Biomarkers in early diagnosis of bacterial and aseptic meningitis
Article Sidebar
Main Article Content
Abstract
Background: Aseptic meningitis has a better prognosis than bacterial meningitis and is less severe. Procalcitonin and hs C-reactive protein levels are helpful markers for identifying and differentiating between aseptic and bacterial meningitis.
Objective: To diagnose meningitis early and minimize treatment gaps, the present study was designed to determine the levels of procalcitonin and hs C-reactive protein in patients with aseptic meningitis and bacterial meningitis.
Material & Methods: It is a cross-sectional study. Both males and females with meningitis symptoms who were >2 to 12 years old were included. The automated analyzer was used to assess the procalcitonin and hs C-reactive protein levels in each subject. Data analysis was done with IBM-SPSS 27.0.
Result: Positive hs C-reactive protein was found in 68.96% of patients with bacterial meningitis and 6.25% of patients with aseptic meningitis, however, there was no statistically significant association (p=0.328). In the meanwhile, procalcitonin was positive in 12.50% of aseptic meningitis patients and 75.86% of bacterial meningitis patients, with a statistically significant association (p=0.001).
Conclusion: Bacterial meningitis had considerably greater hs C-reactive protein and procalcitonin levels as compared to aseptic meningitis patients. The procalcitonin levels were more associated with bacterial and aseptic meningitis. Procalcitonin can be used as an early diagnostic tool to diagnose and differentiate bacterial and aseptic meningitis.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Hoen B, Varon E, de Debroucker T, Fantin B, Grimprel E, Wolff M, et al. Management of Acute Community-Acquired Bacterial Meningitis (Excluding Newborns). Long Version With Arguments. Med Mal Infect. 2019;49(6):405-41.
Tavares T, Pinho L, Bonifácio Andrade E. Group B Streptococcal Neonatal Meningitis. Clin Microbiol Rev. 2022;35(2).
Khosravi S, Dezfouli SMM. Investigating the Rapid Method of Diagnosing Meningitis in Humans. J Crit Rev. 2020;7(13):275-80.
Wright WF, Pinto CN, Palisoc K, Baghli S. Viral (Aseptic) Meningitis: A Review. J Neurol Sci. 2019;398:176-83.
Pormohammad A, Behboudi E, Ramezani A, Shojaei MR, Makvandi M, Zeynali P, et al. Global Study of Viral Meningitis: A Systematic Review and Meta-Analysis. Int J Pediatr. 2022;10(4):15865-80.
Tattevin P, Tchamgoué S, Belem A, Bénézit F, Pronier C, Revest M. Aseptic Meningitis. Rev Neurol (Paris). 2019;175(7-8):475-80.
Taxirovich AS. The Main Etiological Factors, Methods of Prevention and Treatment of Meningitis. Int J Sci Trends. 2023;2(2):141-8.
Yekani M, Memar MY. Immunologic Biomarkers for Bacterial Meningitis. Clin Chim Acta. 2023;517:117470.
Zandstra J, Jongerius I, Kuijpers TW. Future Biomarkers for Infection and Inflammation in Febrile Children. Front Immunol. 2021;12:631308.
Cleland D, Eranki A. Procalcitonin. StatPearls [Internet]. 2023 Jan [cited 2024 Aug 19]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535415/
Xu H-G, Tian M, Pan S-Y. Clinical Utility of Procalcitonin and Its Association With Pathogenic Microorganisms. Crit Rev Clin Lab Sci. 2022;59(2):93-111.
Omer I, Abuthiyab N, Al Zaid N, Alkanani R, Abualnaja R, Khan G. Procalcitonin as a Tool to Antimicrobial Stewardship in COVID-19 Patients With Superimposed Bacterial Infections: A Systematic Review. J Inflamm Res. 2023;16:6055-64.
Alhomsi K. Study of Acute Bacterial Meningitis: Demographics, Symptoms and Signs. Chem Res. 2020;5(6):21-4.
Abyaz S, Jalali MT, Ekrami A, Kaydani G, Bashiri Y. Investigate and Comparison of Serum Level Markers Lactate, hs-CRP and CDT for Differentiating Bacterial Meningitis From Non-Meningitis Patients With Similar Clinical Symptoms. J Res Med Dent Sci. 2018;6(3):393-9.
Kim H, Roh Y-H, Yoon S-H. Blood Procalcitonin Level as a Diagnostic Marker of Pediatric Bacterial Meningitis: A Systematic Review and Meta-Analysis. Diagnostics. 2021;11(5):846.
Rahman SN, Alam J, Sarkar PK, Hossain SM, Jahan SS. Study of CSF C-Reactive Protein for the Differentiation of Bacterial Meningitis From Aseptic Meningitis in Children. Sch J App Med Sci. 2022;11:1925-9.
Thakur S, Loomba R, Loomba V, John M. CSF C-Reactive Protein in Meningitis. J Indian Acad Clin Med. 2020;21(3-4):123-6.
Mintegi S, García S, Martín MJ, Durán I, Arana-Arri E, Fernandez CL, et al. Clinical Prediction Rule for Distinguishing Bacterial From Aseptic Meningitis. Pediatrics. 2020;146(3).
Alnomasy SF, Alotaibi BS, Mujamammi AH, Hassan EA, Ali ME. Microbial Aspects and Potential Markers for Differentiation Between Bacterial and Viral Meningitis Among Adult Patients. PLoS One. 2021;16(6).
Castagno E, Aguzzi S, Rossi L, Gallo R, Carpino A, Ricceri F, et al. Clinical Predictors and Biomarkers in Children With Sepsis and Bacterial Meningitis. Pediatr Emerg Care. 2023;39(5):311-7.
Waterfield T, Maney J-A, Lyttle MD, McKenna JP, Roland D, Corr M, et al. Diagnostic Test Accuracy of Point-of-Care Procalcitonin to Diagnose Serious Bacterial Infections in Children. BMC Pediatr. 2020;20(1):366.
Go H, Nagano N, Katayama D, Akimoto T, Imaizumi T, Aoki R, et al. Diagnostic Accuracy of Biomarkers for Early-Onset Neonatal Bacterial Infections: Evaluation of Serum Procalcitonin Reference Curves. Diagnostics. 2020;10(10):839.