Diagnostic Value of Serum and Cerebrospinal Fluid Procalcitonin in Differentiation Bacterial from Aseptic Meningitis

Abstract

Problem statement: Acute bacterial meningitis is one of the most important causes of medical emergency diseases, which can cause high mortality and morbidity rates. Early antibiotic therapy is life saving in bacterial meningitis. One of the most common etiologies of acute meningitis is viral. Differentiation between bacterial and Aseptic meningitis is mandatory, which leads to avoid useless administration of antibiotics. Various diagnostic tests are available for diagnosis of acute bacterial meningitis; one of these tests is serum procalcitonin. Approach: This survey is a descriptive crosssectional study. During a 2 year period 50 patients over 13 years old who were admitted to Sina and Emam Reza hospitals of Tabriz University of Medical Sciences with presumptive diagnosis of acute meningitis were selected. Serum and Cerebrospinal Fluid (CSF) procalcitonin of the patients were measured by semiquantative chromatographic PCT-Q Assay. Statistical data's of the patients were analyzed by SPSS 15. Results: 38% of the patients had acute bacterial and 62% aseptic meningitis, on the basis of positive clinical and lab tests. 0.5ng mL⁻¹ of serum pricalcitonin was cut off point, which correlated to sensitivity of 100%, positive predictive value of 82.6%, specificity of 87.09% and negative predictive value of 100%. CSF procalcitonin cut off of 0.5ng mL⁻¹ had sensitivity of 100% specificity of 84.21%, positive predictive value of 88.88% and negative predictive value of 90.62%. Conclusion: Serum procalcitonin cut off of 0.5 ng mL⁻¹ has sensitivity and negative predictive value of 100%. This test can be a valuable measure in screening and differentiation of bacterial from aseptic meningitis.