The Role of Cerebrospinal Fluid High-Sensitivity C–Reactive Protein (CSF hsCRP) in Distinguishing Bacterial Meningitis from Aseptic Meningitis

Abstract

One of the most prevalent serious diseases in newborns and infants is meningitis. Aseptic meningitis is generally less severe than bacterial meningitis and often has a better prognosis. CRP level is the most useful criterion for diagnosing feverish children with significant infections. Objective: The present study aimed to determine the level of CRP in CSF of bacterial meningitis, and aseptic meningitis for early prediction of meningitis and remove the lapse in its treatment. Methods: This cross-sectional study was conducted at the Immunology Department of The Children’s Hospital & the Institute of Child Health from Jan 2022 to Jan 2023. The present study enrolled patients who had meningitis symptoms (fever, headache, vomiting, and neck stiffness), aged between >2 years to 12 years, both male and female gender. The CRP levels of all patients were measured using the agglutination method. Data were analyzed using IBM-SPSS version 26.0. Results: Of the total 45 patients, 20 (44.4%) were males and 25 (55.6%) were females. The mean age of patients was 5.98+2.792 years. From total, 29 (64.4%) had bacterial meningitis while 16 (35.6%) had aseptic meningitis. The 09 (31.03%) bacterial meningitis patients had positive CRP (>3.0mg/L). The present study showed a statistically significant association between CSF-CRP results with bacterial and aseptic meningitis (p=0.003). Conclusions: While awaiting the results of other confirmatory tests, CSF-CRP can be utilized as an early diagnostic tool for the identification of bacterial and aseptic meningitis. Additionally, it could aid in the early diagnosis of aseptic vs bacterial meningitis.