A study to observe quantitative levels of C- Reactive Protein in Cerebrospinal fluid in patients with Meningitis as an add-on routine investigation- a case-control study

Abstract

Introduction: C-reactive protein (CRP) is a member of the class of acute phase reactants as itslevel rises dramatically during inflammatory processes occurring in the body. Measuring and chartingCRP values can prove useful in determining the disease progress. Aim: To estimate the CRP level inCerebrospinal fluid (CSF) of patients with meningitis; and to evaluate whether CRP levels could beused to differentiate the various types of meningitis in adults. Materials and Methods: This studywas a case-control study. 80 enrolled patients were subjected to a protocol that included detailedclinical history including duration of illness, symptoms and signs, history or any treatment history.Written informed consent was taken from the patients/guardian. Results: Meningitis was morecommon in the 18-30 years age group. Mean values of CSF CRP were- viral meningitis (2.70 mg/L)and pyogenic meningitis (91.13 mg/L) and control group (1.54 mg/L). CSF CRP can be used as adiagnostic tool to differentiate between pyogenic and viral meningitis as it is significantly raised inpyogenic meningitis in comparison to viral meningitis (p-value <0.0001). Conclusion: CRP in CSF isa valuable, rapid, bedside diagnostic test for differentiating between pyogenic and viral meningitis;with reasonably good sensitivity, specificity and positive predictive value. The absence of CRP in CSFrather than its presence is more important for the diagnosis of viral meningitis.