Differential diagnosis value of serum calcitonin level in children with purulent meningitis and viral meningitis

Abstract

Objective To investigate the value of serum procalcitonin (PCT) level in the differential diagnosis of purulent meningitis and viral meningitis in children. Methods Clinical data of 47 children with acute meningitis, admitted to our hospital from January 2013 to January 2015, were analyzed. Among them, 21 were purulent meningitis and 26 were viral meningitis. All children accepted tests as cerebrospinal fluid, serum PCT, C-reactive protein (CRP), and erythrocyte sedimentation (ES) inspection; and comparison of results between the two groups was performed. Results The PCT, CRP and ES levels in the purulent meningitis group were (51.96±30.72) μg/L, (182.33±54.49) mg/L, (50.41±892) mm/h; and those in the viral meningitis group were (0.81±0.96) μg/L, (8.87±10.63) mg/L and (16.72±13.20) mm/h; significant differences were noted between the two groups (P<0.05). There were 3 children with viral meningitis having PCT level higher than 0.5 μg/L, while all patients with purulent meningitis having PCT level higher than 0.5 μg/L, enjoying sensitivity and specificity of 100% and 88.46%. There were 8 children with viral meningitis having ES level higher than 20 mm/h, while 19 patients with purulent meningitis having ES level higher than 20 mm/h, enjoying sensitivity and specificity of 90.48% and 69.23%. Area under receiver operating characteristic curve of PCT was 0.982 (95%CI=0.951-1.011), CRP was 0.981 (95%CI=0.952-1.010), without difference. Conclusion PCT has an important diagnostic value in the differential diagnosis of purulent meningitis and viral meningitis in children, which is better than ESR diagnosis. Key words: Procalcitonin; Purulent meningitis; Viral meningitis; Differential diagnosis