[Rapid diagnosis of the type of meningitis (bacterial or viral) by the assay of serum procalcitonin].
OBJECTIVE
It has been shown that serum procalcitonin (PCT) can be used to differentiate bacterial from viral meningitis in children in all cases. The aim of this study was to demonstrate the interest of PCT in the management of suspected meningitis in adults.


METHODS
We conducted a prospective study including 179 consecutive patients admitted to the emergency department for suspected meningitis. All samples were taken at patient admission. The discriminant potential between bacterial and viral meningitis was studied for cerebrospinal fluid parameters (cytology, protein, glucose, lactate) and serum parameters (C reactive protein, PCT).


RESULTS
Thirty-two patients had bacterial meningitis, 90 had viral meningitis and meningitis was ruled out in 57. Among all studied parameters, the most discriminant for distinguishing between bacterial and viral meningitis in 100% of the cases proved to be serum procalcitonin with a threshold value of 0.93 ng/ml.


CONCLUSIONS
Serum procalcitonin is an interesting parameter in the emergency department for management of meningitis suspicion in adults.
Viallon
A
A
Service d'Urgence et Réanimation médicales, Hôpital Bellevue, CHU de Saint-Etienne. alain.viallon@univ-st-etienne.fr
Pouzet
V
V
Zéni
F
F
Tardy
B
B
Guyomarc'h
S
S
Lambert
C
C
Page
Y
Y
Bertrand
J C
JC
D000257:Adenoviridae Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D000328:Adult; D002116:Calcitonin / Q000097:blood* / Q000134:cerebrospinal fluid; D015740:Calcitonin Gene-Related Peptide; D002644:Chickenpox / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D003627:Data Interpretation, Statistical; D003937:Diagnosis, Differential; D004769:Enterovirus Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D005260:Female; D006023:Glycoproteins / Q000097:blood* / Q000134:cerebrospinal fluid; D006562:Herpes Zoster / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D006566:Herpesviridae Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D016920:Meningitis, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D008583:Meningitis, Haemophilus / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D008584:Meningitis, Listeria / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D008585:Meningitis, Meningococcal / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D008586:Meningitis, Pneumococcal / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D008587:Meningitis, Viral / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D008875:Middle Aged; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood* / Q000134:cerebrospinal fluid; D012680:Sensitivity and Specificity
C000606589:CALCA protein, human; D006023:Glycoproteins; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide