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Cerebrospinal LDH and Serum Pct in Diagnosis of Meningitis

Sayed Farouk Mohammed, Taha Hussein Singer, Mahmoud Basstawy Ismail and Nagla Abdel Moniem Radi

Context: Meningitis means the membranes that cover the brain, spinal cord and the intervening cerebrospinal fluid inflamed.

Aims: To assess the diagnostic role of cerebrospinal LDH and serum procalcitonin in meningitis and differentiating Septic from Aseptic meningitis.

Settings and design: Cases were divided into septic meningitis (Group I), Aseptic meningitis (Group II), and meningism (Group III) and 100 control cases complain other than CNS infection

Material and methods: Patients were evaluated by full clinical examination, laboratory investigation (CBC, ESR, CRP, & RBS, Liver and Renal function tests, and Blood culture), LP for CSF examination, Cerebrospinal LDH by Spectrophotometer, Serum PCT in selected patient, CT and MRI in complicated cases.

Statistical analysis used: Data were collected and statistically analyzed using: chi square (χ2) test, Spearman correlation coefficient test and Mann-whitney test

Results: It was found that cerebrospinal LDH (100%) of 139 cases in septic meningitis and (98%) of 104 cases in Aseptic meningitis were elevated above normal range. all cases of meningism show normal range. Furthermore, S. PCT testing was positive in all patients with septic meningitis, while S. PCT testing is positive in 35 patients (34%) with Aseptic meningitis and negative in 69 patients (66%). And S. PCT-Q testing was negative in all patients with meningism. control cases were assessed as normal S. PCT level.

Conclusion: Cerebrospinal LDH can be used only as a preliminary screening test, whereas PCT-Q was a good diagnostic marker for distinguishing septic from aseptic meningitis.