The Effectiveness of Laboratory Tests for the Prediction of Acute Bacterial Menengitis in the Pediatric Emergency Department
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Original Research
P: 19-24
April 2015

The Effectiveness of Laboratory Tests for the Prediction of Acute Bacterial Menengitis in the Pediatric Emergency Department

J Pediatr Emerg Intensive Care Med 2015;2(1):19-24
1. İzmir Tepecik Eğitim Ve Araştırma Hastanesi Çocuk Acil Kliniği
2. İzmir Tepecik Eğitim Ve Araştırma Hastanesi Çocuk Yoğun Bakım Kliniği
3. izmir Tepecik Eğitim Ve Araştırma Hastanesi Çocuk Yoğun Bakım Kliniği Ve İzmir Katip Çelebi Üniversitesi Çocuk Yoğun Bakım Bilim Dalı
No information available.
No information available
Received Date: 22.01.2015
Accepted Date: 07.03.2015
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ABSTRACT

OBJECTIVE:

To evaluate the accuracy of laboratory tests in identifying children who had lumbar puncture for suspected bacterial meningitis in the ED.

METHODS:

Retrospective review of the medical records of children with preliminary diagnosis of acute bacterial meningitis and had a lumbar puncture between January 1st, 2008 and December 31st, 2013. All patients presenting to the emergency department (ED) of Izmir Training and Research hospital during the study period. Children who received antibiotics prior to admission to the ED were excluded. The patient population was stratified into three group based on the results of cerebrospinal analysis and culture (CSF); normal, aseptic meningitis, and bacterial meningitis. The results of all laboratory tests were compared between the groups.

RESULTS:

We enrolled 632 patients. The mean age was 42.2 ± 0.8 month (range 1-210 months) and 387 were males. Normal CSF was noted in 205 patients (32.4%), aseptic meningitis 401 patients (63.4%), and 29 (4.6%) had bacterial meningitis. Children with acute bacterial meningitis had a higher level of procalcitonin and lower levels of CSF glucose than children with aseptic meningitis and children with normal CSF (P<0.05). The sensitivity of serum procalcitonin < 24 ng/ml and CSF glucose < 49mg/dl were 95% and 51.8%, specificity was 92% and 70.6% respectively. No significant difference was noted between the groups for total white blood cell count, neutrophil count, serum C-reactive protein, CSF leukocytes or protein level (p>0.05).

CONCLUSION:

Our study results are limited by the small number of patients with acute bacterial meningitis was small in our study population. However, serum procalcitonin appears to accurately identify the majority of children with acute bacterial meningitis in the ED.

Keywords:
menengitis, procalcitonin, CSF glucose, Pediatric emergency