Investigating Procalcitonin and C-Reactive Protein as Diagnostic Biomarkers in Pediatric Suspected Meningitis: A Forward-Looking Observational Analysis

Abstract

Our study is a prospective observational study done on all suspected cases of meningitis admitted to Tertiary Care Hospital, India to study suspected meningitis cases and assess the predictive value of CRP and PCT in diagnosing meningitis. Indian studies are scarce in this regard. We included all clinically suspected cases of paediatric meningitis in our study.Basic investigations, including blood culture and sensitivity, CRP, and PCT, were sentsoon after admission, and CSF analysis and cultures were done once the child became hemodynamically stable. Based on CSF analysis and culture with a clinical profile, meningitis was diagnosed and classified as bacterial and viral meningitis. In this study,we also compared PCT and CRP in their capacity to predict meningitis and to distinguish between bacterial or viral meningitis. A majority of studies have shown that PCT levels can be used in the early diagnosis of bacterial meningitis. In our study, we found that there is no role for PCT in predicting meningitis. CRP has a positive correlation in predicting meningitis but it is elevated in infectious as well as inflammatory conditions. A simple routine complete CSF analysis is an effective, reliable and feasible way to diagnose meningitis in children. This study reiterates the fact that it is indeed the gold standard diagnostic test as no other single parameter can differentiate or diagnose meningitis.