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

Mohammad  Panji; Vahideh  Behmard; Mehri Fallah  Raoufi; Elnaz Sadat Mousavi Sadr  Jadidi; Elham  Rostami; Rahil  Norbakhsh; Vajiheh  Najafi; Tohid Moradi  Gardeshi; Fahimeh  Safizadeh; Haleh  Barmaki

doi:10.18502/ijml.v10i3.13745

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

DOI: https://doi.org/10.18502/ijml.v10i3.13745

Keywords: Bacterial meningitis, Biological marker, Cerebrospinal fluid, Viral meningitis

Abstract

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.