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Category: Volume 05 Issue 07 July 2017
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Title: Estimation of C-Reactive Protein in Serum and Cerebrospinal Fluid for The Diagnosis of Various Meningitis

Authors: Dr Rajmani, Dr Urvashi, Dr Akash Ramchandani

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.254

Abstract

Introduction: Meningitis is a neurological emergency with high mortality and morbidity in the past few years. It is highly desirable to have tools which could be used to diagnose and differentiate between bacterial and non bacterial meningitis with high accuracy. In the best of our knowledge, diagnostic uses of CSF & serum CRP estimation in differentiating bacterial and non bacterial meningitis have been evaluated in very few studies in our country and hence the present study was conducted.

Aims: Our aim was to estimate the levels of CRP in CSF and serum in patients of meningitis to differentiate various types of meningitis.

Material & Method: The present case control study was conducted in dept of medicine J.L.N. Medical College & Hospital, Ajmer. We include 60 patients each in both study and control group. These patients were further divided into three groups as Pyogenic meningitis (PM) group, Tubercular meningitis (TBM) group and viral meningitis (VM) group.

Result: CSF CRP qualitative test was positive in 83.33% cases of PM group while this was negative in all other groups. Serum CRP qualitative test was 100% positive in PM and TBM groups. This was negative in all cases of VM and control groups. In PM group CSF CRP level was 24± 14.98 mg/L (range<6-96 mg/L). In TBM, VM and control groups levels were <6mg/L. In PM group serum CRP level was 128± 110.23 mg/L (range 24-384 mg/L). In TBM group level was 25.85±10.36 mg/L (range 12-48mg/L). In VM and control groups levels were <6mg/L in all cases. Serum CRP value was highly significant in PM and TBM groups in comparison of VM and Control groups. There was no difference between PM and TBM group. CSF CRP level was highly significant in PM group in comparison of TBM, VM and Control groups. There was no difference in TBM groups when compared with VM and Control groups.

Conclusion: CSF CRP estimation was highly sensitive to diagnose and differentiate pyogenic meningitis from tubercular and viral meningitis, while serum CRP was highly sensitive to diagnose and differentiate pyogenic and tubercular meningitis from viral meningitis. 

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Corresponding Author

Dr Urvashi

2/4 Old Heera Bagh Flats, Near SMS Hospital & Narayan Singh Circle. Jaipur Rajasthan 302004