The Specificity, Sensitivity, and Diagnostic Accuracy of CSF-CRP in the Diagnosis of Acute Bacterial Meningitis- A Hospital-Based Study

Abstract

Introduction: Bacteria that enter the bloodstream and mobile to the brain cord cause bacterial meningitis. The disease is less frequent in developed countries compared to developing countries. In Bangladesh, bacterial meningitis constitutes 25% and the case fatality rate was 14%. The mortality from meningitis is near 100% in untreated individuals and can still be up to 40% in children who received appropriate antibiotic therapy in developing countries. Aim of the Study: The study aims to investigate the specificity, sensitivity, and diagnostic accuracy of CSF-CRP in the diagnosis of Acute Bacterial Meningitis (ABM). Methods: An observational cross-sectional study was carried out in the Department of Pediatric Medicine, Dhaka Shishu Hospital (DSH), from 01 Jan-2017 to 30 Jun-2017. A total of 100 patients were enrolled in this study following the inclusive criteria. Data were collected using the predesigned semi-structured questionnaire. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. Result: Among the study population majority of patients (43, 43.0%) were 0-2 years old. One-third of bacterial meningitis (35,35.0%) occurs commonly at an early age (0-2 years). Out of fifty- seven cases (n=57) of bacterial meningitis, twenty-two cases were culture negative and thirty-five cases were culture positive. In the case of bacterial meningitis, in fifty-one cases (51,89.4%) out of fifty-seven, the CSF CRP test was truly positive, with mean±SD 21.7±10.9, false negative were only six cases (6, 10.5%). In aseptic meningitis thirty-nine cases (39,90.6%) out of forty-three cases, the CSF-CRP test was truly negative, and false positive were four cases (4,9.3%). The sensitivity of CSF CRP in differentiating bacterial meningitis from aseptic meningitis was 89.47%, specificity 90.69%, & diagnostic accuracy was 90%. Conclusion: Bacterial meningitis is fatal and more communal in children under one year of age to sixteen years of age. Increased consciousness and initial gratitude and apposite antibiotic treatment can decrease morbidity and mortality. Diagnostic accuracy can be applied as the initial test for the diagnosis of bacterial meningitis.