The Significance of Serum C-Reactive Protein in Childhood Acute Meningitis


Serum concentrations ofC-reactive protein is considered an important diagnostic test for sepsis because itincreases several folds in response to bacterial infection. All over the worldbacterial meningitis is asignificant cause of childhood morbidity and mortality, so early diagnosis and treatment are the most important ways in prevention of the complications.The aim of this study was toestimate the usefulness of serum CRP level in differentiation between septic and aseptic meningitis.We measured the serum CRP level in patients who were diagnosed by clinical and laboratory findings as pyogenic and aseptic meningitis. It was found that partially treated meningitis was most common in all age group,and there is significant correlation between high serum CRP titer and positive CSF culture p.value0.004. Serum CRP was of high titer in 23 (82%) patients with pyogenic meningitis, while its negative in70% of patients with viral meningitis. Fever was the most common presenting symptom in all age group 99(90%) of patients. Patients with Meningeal sign (neck stiffness) were 29(87.8%) in those more than one year from total 33 patients and headache 19(82.6%) from total 21 patients.There is a good sensitivity for serum–CRP, while there is a high specificity for CSF culture and a good specificity for CSF gram stain in pyogenic meningitis. CSF leukocyte polymorphs significantly increased in pyogenic meningitis ,p.value 0.008. while lymphocytes significantly increased in viral meningitis, p.value 0.002. CSF protein: Increase >100mg/dl in 86% of patients with pyogenic meningitis.CSF glucose was significantly decreased in pyogenic meningitis p.value 0.004.We conclude from this studythatserum CRP can helptodistinguish betweenpyogenicand aseptic meningitis. Children who present with clinical feature of meningitis in whom serum CRP values are determined at 12 hour after the onset of fever and are < 6 mg/L are less likely to have pyogenic meningitis. Serum CRP detection is not expensive, simple and dependable diagnostic indicator in meningitis.