Journal of AdvancedMedical and Dental Sciences Research

Aim: To evaluate the CSF C-reactive protein in meningitis to differentiate bacterial meningitis from aseptic meningitis in children. Methods: The Prospective, Observational study was conducted in the Department of pediatrics. 130 children between 1 month to 12 years of age admitted with acute history of fever and seizure were included in the study. Patients were divided into 3 groups based on clinical and CSF findings. Group 1 (Bacterial meningitis) was defined by a CSF leukocyte count of 100–10,000/mm3 with polymorphonuclear neutrophils (PMNs) of >50%, a CSF glucose level <2/3 blood sugar level, and a CSF protein level of 100-500 mg/dl with bacteria isolated from CSF culture. Group 2 (Aseptic Meningitis) was defined as those with a CSF pleocytosis of <100/mm3 with lymphocyte predominance, protein levels of 50-200 mg/dl, and normal glucose levels with a negative bacterial culture and Gram stain. Group 3 (No meningitis/Control Group) included patients with fever and convulsions but normal CSF study. Results: During the study period 130 patients were enrolled in our study after written informed consent was obtained. 85(65.38% of our cases were males. The mean age of our cases was 76.25±42.69 months. Depending on the CSF cytology, biochemistry and bacteriology 50 cases had bacterial meningitis and were included in Group 1, 45 cases had Aseptic Meningitis and were included in Group 2 and 35 cases had no meningitis hence included in Group 3. CSF-CRP was positive in 36 (72%) cases of Bacterial meningitis, 7(15.56%) cases of aseptic meningitis and negative in all cases of control group. The Sensitivity 73.26%, Specificity 86.87%, Positive Predictive Value (PPV) 85.98%, Negative Predictive Value (NPV)74.77% and Diagnostic Accuracy (DA) 80.28% of CSF-CRP for diagnosis of bacterial meningitis. Conclusion: We concluded that CSF-CRP has a high sensitivity, specificity, NNV, PPV and diagnostic accuracy and can be used as an initial test for the diagnosis of Bacterial Meningitis till other confirmatory test reports are awaited.