Estimation of biochemical markers in differential diagnosis of meningitis in a tertiary care hospital

Abstract

Background: The clinical syndrome of meningitis is caused by inflammation of the meninges. Infections due to viruses, bacteria, mycobacterium, fungi, and other organisms are the most frequent causes of meningitis. It may contribute to extreme long-term neurological sequelae such as deafness, epilepsy, hydrocephalus, and cognitive deficits, if not recognized earlier. Our aim was to evaluate the cerebrospinal fluid (CSF)-adenosine deaminase (ADA), lactate dehydrogenase (LDH), glucose, and protein in differential diagnosis of meningitis. Materials and Methods: A total of 60 meningitis patients, of which 26 tubercular, 18 bacterial, and 16 viral meningitis, were analyzed based on the data from the initial clinical examinations. Results: Increased level CSF-ADA was found in tubercular meningitis as compared to bacterial and viral meningitis. Increased levels of CSF-LDH and protein were found in bacterial meningitis as compared to tubercular and viral meningitis, whereas the decreased level of CSF-glucose in bacterial meningitis as compared to tubercular meningitis, while normal level in viral meningitis. Conclusion: CSF-ADA, LDH, glucose, and protein may be sensitive biochemical markers for diagnosing and differentiating meningitis. CSF-ADA was higher in patients with tubercular meningitis as compared to bacterial and viral meningitis, and LDH activity was higher in patients with bacterial meningitis as compared to tubercular and viral meningitis. CSF-glucose was very low and CSF-Protein was very high in both bacterial and tubercular meningitis as compared to viral meningitis.