الملخص الإنجليزي
Objectives: This study aimed to test whether C-reactive protein (CRP) measurement could differentiate
between different types of meningitis and become a routine test. Methods: A prospective study included 140
children admitted to Manipal Teaching Hospital, Pokhara, Nepal, between July 2009 and June 2011. The subjects
had a blood test and detailed cerebrospinal fluid (CSF) analysis, including blood and CSF CRP levels. Results: Of
those admitted, 31.1% had pyogenic meningitis (PM), 26.2% partially treated meningitis (PPM), 33% viral meningitis
(VM), and 9.7% tubercular meningitis (TBM), with 26.4% controls. Organisms were isolated in 12.5% of the cases by
blood culture and 25% of cases through CSF culture. Blood CRP was positive in all groups, with the highest values
in PM (53.12 ± 28.88 mg/dl) and PPM (47.55 ± 34.34 mg/dl); this was not statistically significant (P = 0.08). The CSF
CRP levels were significantly higher (P <0.001) in PM (45.75 ± 28.50 mg/dl) and PPM (23.11 ± 23.98 mg/dl). The
sensitivity and specificity of blood CRP was 90.62%, 88.88%, 64.7%, 70% and 32.4%, 30.97%, 24.52%, 26.12% and that
of CSF CRP was 96.87%, 66.66%, 20.58%, 10% and 74.73%, 63.71%, 50.94%, 55.35% for PM, PPM, VM and TBM,
respectively. Conclusion: Because of its high sensitivity, both CSF CRP and blood CRP can be used to screen for
bacterial meningitis (both PM and PPM). CSF CRP screening yielded results with a higher specificity than blood
CRP; hence, it can be a supportive test along with CSF cytology, biochemistry, and microbiology for diagnosing
meningitis.
