Evaluating Utility of C - reactive Protein in Differentiating Bacterial from Non-Bacterial Meningitis in Tertiary Care Hospital, in Central India

  • Dr. Narmada Prasad Patel Assistant Professor, Department of medicine, L.N. Medical College, Bhopal, India
  • Dr. Umesh Patel L.N. Medical College, Bhopal, India
  • Dr. A C Nagpal N C S B Medical College, Jabalpur, India
  • Dr. R K Jain N C S B Medical College, Jabalpur, India
Keywords: C Reactive protein (CRP), Cerebrospinal fluid (CSF), Meningitis

Abstract

Introduction: Prognosis of CNS infection is critically depends on rapid diagnosis and early implementation of an accurate treatment. Signs and symptoms of CNS infections remain more or less same at the time of initial presentation. Biochemical and cellular analysis of cerebrospinal fluid (CSF) remains main tool in differentiating between Pyogenic meningitis, tubercular meningitis and viral encephalitis. The results of CSF analysis are time consuming and empirical therapy has to start awaiting results of CSF analysis. The authors did a study to evaluate the efficacy of CSF- CRP in differentiating between bacterial and aseptic (viral) meningitis at bedside.

Material and method: In the present study C – Reactive Protein (CRP) in Cerebrospinal fluid (CSF) were studied with latex agglutination method in 58 cases. The authors recruited patients clinically diagnosed as having acute meningitis in department of Medicine, NSCB Medical College, Jabalpur, Madhya Pradesh (India).

Results: CSF-CRP was positive in 15 (83.3%) out of 18 in Pyogenic meningitis, 5 (25%) out of 20 in Tubercular meningitis. CSF-CRP levels in all case of Encephalitis (total of 10) and control (total of 10) were negative.

Conclusion: Measurement of CSF-CRP with latex agglutination can be a good parameter in diagnosis and differentiation of C.N.S infections. Since CRP in CSF can be performed bedside, easy to process, take minimum time and most important very cheap, it can be very useful tool in early initiation of accurate treatment before detail CSF parameters are available and hence improve patient’s outcome in bacterial and nonbacterial meningitis.

Downloads

Download data is not yet available.

References

1. De Beer FC, Kirsten GF, Gie RP, Beyers N, Strachan AF. Value of C reactive protein measurement in tuberculous, bacterial, and viral meningitis.Arch Dis Child. 1984;59(7):653-6. [PubMed]

2. Vaidya AK, Wagle NM, Merchant SM. Use of CSF C-reactive protein in differentiating bacterial and non-bacterial meningitis. J Postgrad Med. 1987;33(2):58-60. [PubMed]

3.Sormunen P, Kallio MJ, Kilpi T, Peltola H. C-reactive protein is useful in distinguishing Gram stain-negative bacterial meningitis from viral meningitis in children. J Pediatr. 1999;134(6):725-9. [PubMed]

4. Peltola HO. C-reactive protein for rapid monitoring of infections of the central nervous system. Lancet. 1982 May 1; 1(8279): 980-2. [PubMed]

5.Clarke D, Cost K. Use of serum C-reactive protein in differentiating septic from aseptic meningitis in children. J Pediatr. 1983;102(5):718-20. [PubMed]

6.Peltola H, Luhtala K, Valmari P. C-reactive protein as a detector of organic complications during recovery from childhood purulent meningitis. J Pediatr. 1984;104(6):869-72. [PubMed]

7.Tillett WS, Francis T. Serological reactions in pneumonia with a non-protein somatic fraction of pneumococcus. J Exp Med. 1930 Sep 30;52(4):561-71. [PubMed]

8.Corrall CJ, Pepple JM, Moxon ER, Hughes WT. C-reactive protein in spinal fluid of children with meningitis. J Pediatr. 1981;99(3):365-9. [PubMed]

9.Tanner AR, Collins AL, Bull FG. The clinical value of rapid C-reactive protein measurement in cerebro-spinal fluid. Clin Chim Acta. 1985;147(3):267-72. [PubMed]

10.Gray BM, Simmons DR, Mason H, Barnum S, Volanakis JE. Quantitative levels of C-reactive protein in cerebrospinal fluid in patients with bacterial meningitis and other conditions. J Pediatr. 1986;108:665-70.[PubMed]

11.Philip AG, Baker CJ. Cerebrospinal fluid C-reactive protein in neonatal meningitis. . J Pediatr. 1983(5);102(5):715-7. [PubMed]

12.Benjamin DR, Opheim KE, Brewer L.Is C-reactive protein useful in the management of children with suspected bacterial meningitis? Am J Clin Pathol. 1984 Jun;81(6):779-82.
CITATION
DOI: 10.17511/ijmrr.2013.i02.02
Published: 2013-06-30
How to Cite
1.
Prasad Patel N, Patel U, Nagpal AC, Jain RK. Evaluating Utility of C - reactive Protein in Differentiating Bacterial from Non-Bacterial Meningitis in Tertiary Care Hospital, in Central India. Int J Med Res Rev [Internet]. 2013Jun.30 [cited 2024Jul.3];1(2):47-4. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/10
Section
Original Article