Author/Editor     Jereb, Matjaž
Title     Diagnostična vloga prokalcitonina pri bolnikih z meningitisom
Type     monografija
Place     Ljubljana
Publisher     Medicinska fakulteta
Publication year     1999
Volume     str. 49
Language     slo
Abstract     Meningitis is a common disease in our place. Particularly in case of bacterial central nervous system infection it continues to cause significant mortality, despite the advances in antibiotic and intensive care therapy. Rapid diagnosis and therapy have crucial influence on clinical outcomes. Patients with viral meningitis have not so rarely clinical and laboratory parameters of bacterial infection which usually lead to unnecessary antibiotic therapy. Delay of antimicrobial treatment could be on the other side fatal in case of noncharacteristic bacterial meningitis. During the last few years several studies have been reported on the new inflammation peptid procalcitonin (PCT), which concentration increases in the setting of bacterial infection. In the present study we wanted to find out whether there is any difference in plasma PCT level between patients with bacterial meningitis and patients with viral infection of central nervous system, and if measurement of PCT level in cerebrospinal fluid might have additional diagnostic value. Seventeen patients with purulent and 28 patients with aseptic meningitis were included in the prospective clinical study. The mean plasma PCT level in patients with purulent meningitis was 11.50 ng/ml and mean plasma PCT level in patients with aseptic meningitis was 0.28 ng/ml (p<0.001). Two patients in purulent meningitis group had plasma PCT level under a cutoff value of 0.5 ng/ml. In both cases Listeria monocytogenes has been isolated from cerebrospinal fluid. No one in aseptic meningitis group had eleveted PCT level. Eight patients with purulent meningitis had elevated PCT level in cerebrospinal fluid and in all cases PCT in plasma was high. The measurement of PCT in plasma and cerebrospinal fluid might be of value in the differential diagnosis of meningitis due to either bacteria or viruses. PCT value higher then 0.5 ng/ml appears to be a reliable indicator of bacterial central nervous system infection.
Descriptors     MENINGITIS
ACUTE-PHASE PROTEINS
BACTERIAL INFECTIONS
C-REACTIVE PROTEIN
CALCITONIN
IGG
GLYCOPROTEINS