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C-Reactive Protein Concentrations in Cerebral Spinal Fluid in Gram-positive and Gram-negative Bacterial Meningitis

¹ Department of Clinical Biochemistry, Hadassah Mount Scopus Hospital, Hebrew University, Hadassah Medical School, Jerusalem 91120, Israel

² Department of Clinical Microbiology, Hadassah Mount Scopus Hospital, Hebrew University, Hadassah Medical School, Jerusalem 91120, Israel

^aAuthor for correspondence. E-mail mayer@hadassah.org.il.

To the Editor:

Several reports have shown an ability of C-reactive protein (CRP) to discriminate between patients with bacterial meningitis and patients with aseptic (viral) meningitis (1)(2). Although a recent metaanalysis suggested that a negative CRP test in either cerebrospinal fluid (CSF) or serum can be used with a very high probability to rule out bacterial meningitis (3), a more recent report (4) suggested that serum concentrations are a better screening tool for this differential diagnosis.

To assess the ability of CSF CRP to differentiate gram-positive from gram-negative meningitis, we compared CRP concentrations in the blood and CSF, along with CSF nitric oxide (NO), protein, glucose, and leukocyte count, in 17 consecutive patients (age range, 2 months to 47 years) with suspected bacterial meningitis and in noninfected controls. The two patient groups had comparable CSF leukocyte counts and protein and glucose concentrations, and were not considerably different with respect to dispersion of gender . . . [Full Text of this Article]

References

The following articles in journals at HighWire Press have cited this article:

				M. B. Chitkara, L. M. Ryan, D. Stockwell, and B. L. Wiedermann Can a Clinical Decision Rule Decrease Antibiotic Use in Viral Meningitis? Arch Pediatr Adolesc Med, December 1, 2002; 156(12): 1195 - 1198. [Full Text] [PDF]