Abstract
Neonatal purulent meningitis is a significant cause of neonatal disability and death. The early diagnosis and effective treatment are critical for neonatal purulent meningitis. Procalcitonin (PCT) is currently used as a clinical diagnosis marker of inflammation and infection, such as sepsis. Due to the lower immunity of neonates and the atypical symptoms of neonatal purulent meningitis, it is challenging to obtain reliable information of the development, diagnosis, treatment and prognosis of neonatal purulent meningitis. This study monitored the dynamic change of the PCT levels in 48 neonatal patients after the standard treatment and found out that the PCT level may not be a distinguish diagnosis marker but a useful indicator for efficacy of the treatment and prognosis specifically in neonatal purulent meningitis.
Highlights
Neonatal purulent meningitis usually happens in infants within three months old and caused by varies bacterial spread and rapid multiplying in the subarachnoid space of the meninges
Among several infectious conditions including neonate purulent meningitis the PCT level was a more sensitive indicator than Creactive protein (CRP), the increased range of the PCT levels in neonate purulent meningitis was overlapped with systemic inflammatory response syndrome (SIRS) and neonatal sepsis [10]
PCT levels were found significantly higher in patients with bacterial meningitis and other cerebrospinal fluid (CSF) parameters, such as blood leukocytes, and CRP showed overlapping values [11]
Summary
Neonatal purulent meningitis usually happens in infants within three months old and caused by varies bacterial spread and rapid multiplying in the subarachnoid space of the meninges. The common clinical signs of neonatal purulent meningitis, including fever, poor feeding, lethargy and seizure, are commonly shown up in other pathological conditions such as bacterial infection and pneumonia [1,2]. Blood PCT level in a healthy adult is relatively low and even below the common clinical detection limitation. PCT level has been reported as a biomarker for early diagnosis of bacterial infection with a sensitivity of 76% and specificity of 70% [1,5,6]. In a cluster randomized clinical trial the level of PCT was successfully used to guide antibiotic therapy in a pneumonia treatment [7] while in another study it was reported with limited prognostic value [8]. To clarify whether PCT can be used as a clinical iagnosis/prognosis marker for neonatal purulent meningitis, we conducted this study that comprised 48 neonatal patients with purulent meningitis
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