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The role of CSF-CRP in diffrentation between bacterial from nonbacterial meningitis.

Qassim Mohammed Hashim, Hidhab Jawad Muhsin, Sahar A Majeed, Jasim Mohammed Hashimand Alaa MaanJohny, Alaa Jumaah Manji Nasrawi*

Background: Meningitis is one of dangerous disease in children and the differentiation between acute bacterial and non- bacterial meningitis (particularly viral meningitis) is so important because they differ in their prognosis and treatment. CSF culture and gram stain is ideal for diagnosis but it is coasty and time consuming,so looking for biological markers like CSF-CRP to simplify the accuracy of initial diagnosis of acute meningitis. Objective: To find out the significance of CSF-CRP in patients with bacterial meningitis. Methods: Cross sectional study performed in Babylon teaching hospital on 45 clinically suspected meningitis patients were evaluated for Serum CBC, CRP, Lumbar puncture and CSF examination. Immediately after hospital admission, lumbar puncture and Cerebrospinal Fluid (CSF) examination (bacteriological, cytological and chemical) were done for all patients. Results: CSF-CRP level was remarkably increased in bacterial meningitis (mean 6.59 ± 5.81 mg/l) in comparison with non-bacterial meningitis (mean 1.14 ± 2.36 mg/l), (p<0.001). There are positive relations with WBC and CRP in non-bacterial and bacterial meningitis but this correlation become greatly significant with bacterial meningitis positive groups. Conclusion: This study shows that CSF-CRP can be used for early diagnosis of bacterial meningitis and may be a helpful association in differentiation bacterial and non-bacterial meningitis with CBC and serum CRP.