Study of Cerebrospinal Fluid C-reactive Protein in Children with Meningitis between 1 Month and 12 Years of Age

Abstract

Background: India is a growing nation with few resources and trained workers, especially in terms of outlying infrastructure. As a result, a simple and thorough examination to identify acute bacterial meningitis is required. Regular use of cerebrospinal fluid C-reactive protein (CSF-CRP) in the diagnosis of acute bacterial meningitis may be a quick, accurate, and simple way to diagnose meningitis. As a result, the goal of this study is to examine the specificity, sensitivity, positive and negative predictive values, and diagnostic accuracy of CSF-CRP in the diagnosis of bacterial meningitis. Methodology: In a tertiary care center’s department of pediatrics, between January 2021 and June 2022, a cross-sectional descriptive observational study was carried out. Patients’ demographic data such as age, gender, clinical profile, CSF-CRP, and outcome were recorded. In the current study, each subject underwent a complete examination and comprehensive history before a provisional diagnosis was provided. As part of the diagnostic process, blood and CSF samples were taken. A quantitative immunoturbidometric method was used to determine the level of CSF-CRP. Outcome of the Study: Approximately 130 patients with a history of fever, convulsions, and signs of meningitis were considered, out of which 60 (46.2%) patients were male and 70 (53.8%) patients were female. The majority of cases were found to be positive in the CSF-CRP test, i.e. around 52 (60%), while the distribution based on the CSF culture report showed that 17 cases were positive. The results demonstrated that the CSF-CRP had a sensitivity of 100%, indicating that it correctly identified all positive cases. However, its specificity was 69.02%. Results: Notably, 94.2% of pyogenic meningitis cases had positive CSF-CRP results, while viral meningitis cases had no positive results, and tubercular meningitis had a lower 5.8% positive rate. CSF-CRP was also linked to clinical outcomes, with a significantly higher mortality rate of 9.6% in CSF-CRP positive cases. Conclusion: For the diagnosis of pyogenic meningitis, the culture and Gram stain of CSF is the gold standard. Thus, the early diagnosis of pyogenic meningitis and CSF-CRP is useful and decreases the economic burden and hospital stay of the patients.