Abstract

Meningitis is a life-threatening inflammatory disease of the brain and spinal cord, mostly caused by bacterial and viral infections. Because of the high mortality rate and the possibility of neurological sequelae in survivors, a quick diagnosis with near 100% sensitivity is critical for patients with bacterial meningitis. New biomarkers like procalcitonin may help design an accurate decision tool for the diagnosis of such a condition. The validity of serum procalcitonin in distinguishing between acute bacterial and viral meningitis was evaluated. Method: 40 Adult patients (17 with bacterial and 23 with viral meningitis) were included in this Prospective correlational diagnostic yield study. A non-parametric test was used for hypothesis testing. Sensitivity, specificity, and predictive values for several laboratory parameters were calculated. Result: The median serum procalcitonin level in patients with bacterial meningitis was 1.5 ng/ml (range 0.2-25 ng/ml) and in the group with viral meningitis 0.08 ng/ml (range 0.01-0.2 ng/ml). A serum procalcitonin level > 0.1 ng/ml had a 94% positive predictive value for bacterial meningitis and a 100% negative predictive value. Conclusion: Serum procalcitonin concentrations > 0.1 ng/ml appear to be a reliable indicator of bacterial CNS infection, with high positive predictive values and maximum negative predictive values.

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