Cerebrospinal creatinine kinase level in children with meningitis.
BACKGROUND
The aim of this study is to evaluate the diagnostic value of the enzyme creatine kinase (CK) in the cerebrospinal fluid (CSF) of children with meningitis.


METHODS
CSF samples were collected from seventy one children suspected of having meningitis. The levels of total CK, CK-BB, Glucose, total protein, WBC counts, and culture were determined in the CSF. The cutoff value for total CK in the CSF was defined as 18 U/L.


RESULTS
Three cases (4%) of bacterial meningitis and 11 cases (15%) of aseptic meningitis were confirmed by culture. The sensitivity and specificity of total CK CSF level alone to diagnose bacterial meningitis were found to be 33% and 91% respectively. The positive and negative predictive values were found to be 14% and 98% respectively. On the other hand, the sensitivity and specificity of total CK level in aseptic meningitis were found to be 40% and 98% respectively and the positive and negative predictive values were 86% and 94% respectively. The sensitivity and specificity of total protein and glucose in CSF were also calculated. Streptococcus pneumonia and homophiles influenza were the main types identified in our cases.


CONCLUSIONS
Measuring the total CK level in the CSF may be very useful in diagnosis of meningitis if only combined with other CSF markers. It is not of any much benefit if it is used solely.
Tamimi
Waleed
W
Department of Basic Sciences, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Saudi Arabia. tamimiw@ngha.med.sa
Al-Kharji
Norah Hamad
NH
Alanazi
Melfi
M
Felimban
Naila
N
Al-Khulif
Ali
A
Alharbi
Khalid K
KK
D002556:Cerebrospinal Fluid Proteins / Q000134:cerebrospinal fluid*; D002648:Child; D004796:Clinical Enzyme Tests; D003402:Creatine Kinase / Q000134:cerebrospinal fluid*; D052276:Creatine Kinase, BB Form / Q000134:cerebrospinal fluid; D005260:Female; D005947:Glucose / Q000134:cerebrospinal fluid; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013129:Spinal Puncture
D002556:Cerebrospinal Fluid Proteins; D003402:Creatine Kinase; D052276:Creatine Kinase, BB Form; D005947:Glucose