Meningitis is an important public health problem in developing countries with considerable morbidity and mortality. Early categorisation according to the aetiology of meningitis leads to specific treatment with better outcome. Cerebrospinal fluid (CSF) culture is the gold standard but is not easily available and expensive so a rapid but specific test to differentiate types of meningitis is the need of the hour. So this prospective study was carried out in a tertiary care hospital in Eastern India.

50 patients of meningitis based on clinical, radiological and biochemical profile were recruited and serum C reactive protein (CRP), CSF adenosine deaminase (ADA) & CRP were estimated and analysed with respect to conventional parameters. The mean value of serum CRP in pyogenic meningitis was 54.98 which were considerably higher than tubercular and viral counterparts. CSF CRP was also higher in these patients with a mean value 20.35. In tubercular meningitis the mean CSF ADA is 31.16 which were higher compared to other causes. Taking CSF ADA cut off >10IU/L, 17out of 19 patients had higher levels which was quite significant. The sensitivity, specificity, positive predictive value, diagnostic accuracy of CSF CRP is 94.12%, 100%, 100% and 98% respectively and that for CSF ADA is 89.47%, 96.77%, 94.44% and 94% respectively. So CSF ADA & CRP can be used as early and reliable markers to differentiate meningitis.     

Keywords: Meningitis, CSF CRP, CSF ADA, serum CRP.

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