Abstract

SIGNIFICANCE OF CEREBROSPINAL FLUID (CSF) C-REACTIVE PROTEIN (CRP) IN VARIOUS TYPES OF MENINGITIS

Author(s): Rumi Baruah1, Bhaskar Baruah2, Swaroop Kumar Baruah3 Hafizur Rahman4, Jayasri Medhi5

BACKGROUND Meningitis often presents as a medical emergency which requires rapid and prompt diagnosis with aggressive management to select appropriate therapy to prevent mortality and long-term morbidity. Sometimes clinical signs and symptoms, results of routine CSF analysis and radiological findings are inadequate in making a definitive diagnosis of meningitis. On the other hand, tests like ELISA, Gram’s and AFB stain of CSF are although rapid techniques for detection of organism, have disadvantages of cost, availability and sensitivity respectively. With GeneXpert, diagnosis of Mycobacterium tuberculosis and RIF resistance is now available in less than 2 hours but again has disadvantage of cost and availability. In such circumstances, the determination of CSF CRP appears to provide a new dimension to the additional supportive diagnosis of the type of meningitis. METHODS The study was carried out on 90 patients admitted in the Department of Medicine, Gauhati Medical College & Hospital, Guwahati, Assam. The final diagnosis of the type of meningitis was based on the clinical criteria, biochemical, cytological & bacteriological examination of CSF. RESULTS In our study, the mean CRP in CSF of patients with bacterial meningitis, tubercular meningitis and viral meningitis were 24.00±11.17 mg/dl, 5.27±3.15 mg/dl and 2.57±3.11 respectively. The calculated p values show that the difference is statistically significant (p<0.0001) when the means of bacterial group is compared with the other two. CONCLUSION CSF CRP level can be used to differentiate bacterial meningitis from tubercular and viral meningitis.