title: Serum procalcitonin in septic meningitis.
abstract: OBJECTIVE
  To evaluate the role of serum procalcitonin (PCT) in diagnosis of septic meningitis in children and its efficacy in differential diagnosis.
  
  
  METHODS
  The study included 40 children of septic meningitis admitted in pediatric ward with fever, headache, vomiting and seizure, up to 14 y of age. The diagnosis of septic meningitis was based on clinical features; physical examination, blood and cerebrospinal fluid (CSF) cytochemical findings, gram's stain and bacterial culture. Fifteen cases of aseptic meningitis admitted during same period were also included in the study, and 15 children with normal CSF were taken as control. Serum PCT was measured by ELISA Kit.
  
  
  RESULTS
  Serum PCT level was significantly higher in children with septic meningitis than those with aseptic meningitis or in controls (p < 0.001). In culture and gram's stain positive 7 cases, serum procalcitonin was significantly elevated (24,768.21 ± 6,567.45 pg/mL) than aseptic meningitis(14,451.24 ± 4,266.15 pg/mL) (p < 0.001). Further its level was found significantly elevated in partially treated septic meningitis as compared to aseptic meningitis cases (p < 0.001). At optimum cut off value of ≥ 5,000 pg/mL, based on area under ROC curve, PCT showed sensitivity, specificity, positive predictive value and negative predictive value of 98.5 %, 93.5 %, 98.6 % and 93.3 % respectively. Serum PCT with cut off level of 15,000 pg/ml showed sensitivity, specificity, PPV and NPV of 92 %, 67 %, 91.4 % and 71.4 % respectively for the differentiation of septic from aseptic meningitis.
  
  
  CONCLUSIONS
  Serum PCT may be used as diagnostic marker for septic meningitis and its differentiation from aseptic meningitis.
authors: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors: Rajniti
authors: R
authors: Prasad
authors: Rishi
authors: R
authors: Kapoor
authors: Om Prakash
authors: OP
authors: Mishra
authors: Ragini
authors: R
authors: Srivastava
authors: Utpal
authors: U
authors: Kant Singh
mesh_terms: D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D005840:Gentian Violet; D006801:Humans; D007194:India; D008297:Male; D008582:Meningitis, Aseptic / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy; D016920:Meningitis, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy; D010619:Phenazines; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve
chemical_list: C000606589:CALCA protein, human; C035863:Gram's stain; D010619:Phenazines; D011498:Protein Precursors; D002116:Calcitonin; D005840:Gentian Violet; D015740:Calcitonin Gene-Related Peptide