Evaluation of Biological Markers in Children's Cerebrospinal Fluid with Bacterial and Viral Meningitis

Abstract

Background and Aims: Cerebrospinal fluid (CSF) and blood biomarkers are widely evaluated as diagnostic tools to distinguish between bacterial meningitis and viral meningitis in emergency laboratory tests. So, this aimed to examine the levels of diagnostic parameters in blood and CSF to discriminate between bacterial and viral meningitis in young children referred to Khoy Hospital.
 Materials and Methods: A total of 101 young children with meningitis were enrolled in this prospective study. The diagnosis of bacterial and viral meningitis was based on clinical features and laboratory findings.
 Results: Of the 101 patients with meningitis, 18 (17.82%) were bacterial, and 83 (82.17%) were viral meningitis. The levels of CSF glucose and CSF/blood glucose ratio were significantly lower in the bacterial meningitis group than in the viral meningitis group (p < 0.01). In contrast, white blood cells count, CSF protein, interleukin-6, C-reactive protein, and ferritin levels were significantly higher in patients with bacterial meningitis compared to viral meningitis (p < 0.01). However, there was no difference between viral and bacterial meningitis groups concerning mean serum glucose.
 Conclusion: This study suggests that decreased CSF glucose and CSF/blood glucose ratio and increased white blood cells count, CSF protein, ferritin, interleukin-6, and C-reactive protein combined with clinical symptoms can help better diagnosis of bacterial meningitis, especially in comparison with viral meningitis.