Author:
Ali M. Al‐Balkhi, Faris K. Khadir, Wameedh Q. Al-Sammak and Ameen Al-Alwany
Page: 1-5
Published online: 26 Dec 2024
https://doi.org/10.36478/acepharma.2024.1.6
Acute bacterial meningitis is a life‐threatening infection of the central nervous system with significant morbidity and mortality worldwide. Rapid and accurate diagnosis is essential for initiating appropriate treatment. While cerebrospinal fluid (CSF) analysis remains the cornerstone of diagnosis, biomarkers like C‐reactive protein (CRP) have been investigated as adjunctive tools to improve diagnostic accuracy. This study aimed to evaluate the sensitivity and specificity of CRP in diagnosing acute bacterial meningitis and its utility as a supportive diagnostic tool. A descriptive, prospective, cross‐sectional study was conducted at Baghdad Teaching Hospital Emergency Room and Adult Neurology Outpatient Clinic from January to July 2023. A total of 33 patients aged 18‐70 years presenting with fever and headache underwent lumbar puncture for CSF analysis. CRP levels were measured and compared to CSF culture results to determine their diagnostic utility. Other laboratory parameters, including CSF white blood cell counts, sugar levels and protein levels, were also evaluated. Statistical analysis included Student's t‐test, Chi‐square test and receiver operating characteristic (ROC) curve analysis. The mean CRP level among patients was 13.76±9.76 mg/L. Positive CSF cultures were observed in 63.6% of cases, with a CRP cut‐off value of 8.60 mg/L yielding a sensitivity of 85.7% and specificity of 66.7%. Patients with positive CSF cultures had significantly higher CRP levels (17.20±10.32 mg/L vs. 7.76±4.67 mg/L, p=0.006), elevated CSF WBC counts (195.71±111.46 cells/mm³ vs. 45.50±47.59 cells/mm³, p=0.0001) and more frequent low CSF sugar levels (76.9% vs. 23.1%, p=0.002) and elevated CSF protein levels (77.8% vs. 22.2%, p=0.0001). The diagnostic accuracy of CRP was 78.8%, with a positive predictive value of 81.8% and a negative predictive value of 72.7%. CRP is a valuable adjunctive marker in the diagnostic work up of acute bacterial meningitis but is not definitive on its own. When combined with clinical findings and CSF analysis, CRP can improve diagnostic accuracy. The study is limited by its small sample size and single‐center design, necessitating further multicenter research to validate these findings. Despite these limitations, CRP remains a practical and accessible tool for resource‐limited settings.