Procalcitonin as a potential predicting factor for prognosis in bacterial meningitis.
We investigated the potential role of serum procalcitonin in differentiating bacterial meningitis from viral meningitis, and in predicting the prognosis in patients with bacterial meningitis. This was a retrospective study of 80 patients with bacterial meningitis (13 patients died). In addition, 58 patients with viral meningitis were included as the disease control groups for comparison. The serum procalcitonin level was measured in all patients at admission. Differences in demographic and laboratory data, including the procalcitonin level, were analyzed between the groups. We used the mortality rate during hospitalization as a marker of prognosis in patients with bacterial meningitis. Multiple logistic regression analysis showed that high serum levels of procalcitonin (>0.12ng/mL) were an independently significant variable for differentiating bacterial meningitis from viral meningitis. The risk of having bacterial meningitis with high serum levels of procalcitonin was at least 6 times higher than the risk of having viral meningitis (OR=6.76, 95% CI: 1.84-24.90, p=0.004). In addition, we found that high levels of procalcitonin (>7.26ng/mL) in the blood were an independently significant predictor for death in patients with bacterial meningitis. The risk of death in patients with bacterial meningitis with high serum levels of procalcitonin may be at least 9 times higher than those without death (OR=9.09, 95% CI: 1.74-47.12, p=0.016). We found that serum procalcitonin is a useful marker for differentiating bacterial meningitis from viral meningitis, and it is also a potential predicting factor for prognosis in patients with bacterial meningitis.
Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Bong Soo
BS
Park
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Si Eun
SE
Kim
Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Si Hyung
SH
Park
Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Jinseung
J
Kim
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Kyong Jin
KJ
Shin
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Sam Yeol
SY
Ha
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
JinSe
J
Park
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Sung Eun
SE
Kim
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Byung In
BI
Lee
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea. Electronic address: smilepkm@hanmail.net.
Kang Min
KM
Park
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D008587:Meningitis, Viral / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
D015415:Biomarkers; D002116:Calcitonin
Bacteria; Death; Procalcitonin; Virus