Evaluation of Biological Markers in Children's Cerebrospinal Fluid with Bacterial and Viral Meningitis

  • Mohammad Panji Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
  • Vahideh Behmard Student Research Committee, Department of Midwifery, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
  • Mehri Fallah Raoufi Department of Clinical Science, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
  • Elnaz Sadat Mousavi Sadr Jadidi Department of Basic Sciences, Payame Noor University, Tehran, Iran
  • Elham Rostami Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
  • Rahil Norbakhsh Department of Virology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Vajiheh Najafi Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
  • Tohid Moradi Gardeshi Department of Veterinary Sciences, Garmsar Branch, Islamic Azad University, Garmsar, Iran
  • Fahimeh Safizadeh Iranian Social Security Organization, Kerman, Iran
  • Haleh Barmaki Department of Laboratory Medicine, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Keywords: Bacterial meningitis, Biological marker, Cerebrospinal fluid, Viral meningitis


Background and Aims: Cerebrospinal fluid (CSF) and blood biomarkers are widely evaluated as diagnostic tools to distinguish between bacterial meningitis and viral meningitis in emergency laboratory tests. So, this aimed to examine the levels of diagnostic parameters in blood and CSF to discriminate between bacterial and viral meningitis in young children referred to Khoy Hospital.

Materials and Methods: A total of 101 young children with meningitis were enrolled in this prospective study. The diagnosis of bacterial and viral meningitis was based on clinical features and laboratory findings.

Results: Of the 101 patients with meningitis, 18 (17.82%) were bacterial, and 83 (82.17%) were viral meningitis. The levels of CSF glucose and CSF/blood glucose ratio were significantly lower in the bacterial meningitis group than in the viral meningitis group (p < 0.01). In contrast, white blood cells count, CSF protein, interleukin-6, C-reactive protein, and ferritin levels were significantly higher in patients with bacterial meningitis compared to viral meningitis (p < 0.01). However, there was no difference between viral and bacterial meningitis groups concerning mean serum glucose.

Conclusion: This study suggests that decreased CSF glucose and CSF/blood glucose ratio and increased white blood cells count, CSF protein, ferritin, interleukin-6, and C-reactive protein combined with clinical symptoms can help better diagnosis of bacterial meningitis, especially in comparison with viral meningitis.