The evaluation of the levels of serum CRP and amiloid-A in the diagnosis and follow up of therapy in the meningitis of the children

Abstract

Central nervous system infections have nonspecific clinic symptoms and signs like headache, nausea, vomiting, anorexia, irritability and fever regardless to the etiologic agent. Aseptic meningitis; mostly the result of viral agents and not requiring antibiotic therapy, should be differed from bacterial meningitis promtly. However, this differentations is often difficult. In this study we have evaluated the clinical values of serum CRP and amyloid-A levels in the diagnosis and assessment of therapeutic responce of the childhood meningitis. For the differentiation of acute bacterial and aseptic meningitis and follow up responses to therapy in the children, the level of CRP and SAA have been determined in 15 patients with bacterial and 15 patients with aseptic meningitis. Patients who had positive CSF culture and/or gram staining and/or acute bacterial meningitis probability score greater than 0.1 (Calculated by Hoen formula) were included in the bacterial meningitis group. In the differentiation of bacterial and aseptic meningitis, when 150 mg /L for SAA and 50 mg/L for CRP are used for cut-off value, positive predictive value is % 73.3 for CRP and % 66.7 for SAA. The serum levels of the two acute-phase reactants decrease during the treatment. On the other hand, the decrease in CRP levels over time are not so significant statistically whereas the decrease in SAA levels were significant.