title: Diagnostic value of serum procalcitonin levels in children with meningitis: a comparison with blood leukocyte count and C-reactive protein.
abstract: OBJECTIVE
  To determine the level of serum procalcitonin, blood leukocyte count (TLC) and C-reactive protein (CRP) in children with bacterial and non bacterial meningitis and document their efficacy in differential diagnosis. Also described are procalcitonin levels variation during treatment.
  
  
  METHODS
  From March 2005 to February 2008, we evaluated 38 clinically suspected meningitis patients in the paediatric departments, Al-Jedaany Hospital, Jeddah, KSA, for Serum procalcitonin, CRP, TLC and Lumbar punctures and CSF analysis. Patients were classified into bacterial meningitis group I (18) and non bacterial meningitis group II (20).
  
  
  RESULTS
  Serum PCT levels were significantly higher in bacterial meningitis (BM) {mean 4.8 +/- 3.85 ng/ml (2.9-11.6)} compared with non bacterial meningitis (NBM) {mean 0.38 +/- 0.25 ng/ml (0.31-0.61)} {P < 0.001}. Mean of all CSF parameters, TLC {15,000 +/- 2,900 cell/ml(BM) & 9500 +/- 1105 cell/ml (NBM)} and CRP {20 +/- 6.8 mg/l (BM) & 12.5 +/- 12.0 mg/l (NBM)} showed a zone of overlapping between the two groups. There is a positive correlation between serum PCT, TLC and CRP in bacterial and non bacterial meningitis cases but this relation becomes highly significant with bacterial meningitis positive group. Day 3 and day 6 treatment serum PCT was less than on admission levels (P < 0.001).
  
  
  CONCLUSIONS
  PCT can be used in the early diagnosis of bacterial meningitis and may be a useful adjunct in differentiating bacterial and non bacterial meningitis than CRP or TLC and diminishing the value of lumbar puncture performed 48-72 hours after admission to assess treatment efficacy.
authors.affiliation: Department of Paediatrics, Benha Faculty of Medicine, Benha University, Egypt, Al-Jedaany Hospital, Jeddah, KSA.
authors.forename: Khaled Abdulqawi
authors.initials: KA
authors.lastname: Ibrahim
authors.forename: Alsayed Ahmed
authors.initials: AA
authors.lastname: Abdel-Wahab
authors.forename: Ahmed Sayed
authors.initials: AS
authors.lastname: Ibrahim
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002555:Cerebrospinal Fluid / Q000166:cytology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D008582:Meningitis, Aseptic / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D016920:Meningitis, Bacterial / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D013129:Spinal Puncture
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide