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

Abstract

Introduction : Prognosis of CNS infection is critically depends on rapid diagnosis and early implementation of an a ccurate treatment. Signs and symptoms of CNS infections remain more or less same at the time of initial presen tation. Biochemical and cellular analysis of cerebrospinal fluid (CSF) rema ins main tool in differentiating between Pyogenic m eningitis, tubercular meningitis and viral encephalitis. The results of C SF analysis are time consuming and empirical therap y has to start awaiting results of CSF analysis. The authors did a study to evaluate the efficacy of CSF- CRP in differentiati ng 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 clinica lly 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 mening itis, 5 (25%) out of 20 in Tubercular meningitis. C SF-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 b acterial and nonbacterial meningitis.