Background: Meningitis is a significant cause of morbidity and mortality worldwide. Cerebrospinal Fluid (CSF) analysis is the current gold standard for diagnosis. However, this test does not achieve a high enough sensitivity and specificity to distinguish between bacterial and viral meningitis. So, an urgent need for rapid diagnosis with a higher sensitivity is recommended. Aim of the Work: To assess clinical usefulness of CSF PCT in diagnosis of septic versus aseptic meningitis. Subjects and Methods: This study was conducted after formal consent on 60 patients (pts) presented with a picture of meningitis. They were divided into: Group I (GI) (3Opts with bacterial meningitis), Gil (3Opts with viral meningitis) and GUI controls: 30pta undergoing spinal anesthesia for non. neurological operations. Results: CSF leucocytes and PMN% were higher in bac terial than viral group. Also protein content was higher, while sugar was lower in bacterial versus viral group. The most common pathogen causing bacterial meningitis according to culture was S. pneumonac (36.7%), Meningococci (23.3%) and H. influenza (10.0%). The least common pathogens were Staph (3.3%) & E-cou (3.3) and culture was negative in (23.3%). CSF procalcitonin level was significantly higher in bacterial meningitis than viral meningitis with a mean value384.1 versus 281.1 (pg/mI) with p=O.006. Both meningitis groups had also significantly higher levels of PCT than the controls (186.6 pg/mI) with p.cO.001. ROC curve showed that CSF PCT at level ?216.74pg/ml is diagnostic of meningitis with sensitivity of 83.3%, specificity 66.7%, Positive Predictive Value (PPV) 83.3% and Negative Predictive Value (NPV) 66.7% and AUC (0.83). At level 295ApgJml PCF is diagnostic for bacterial meningitis with sensitivity 76.7%, specificity68.3% , PPV 71.8%, NPV 75% and AUC 0.8. At level |
