Diagnostic Value Of Crp, Pct And Tnf-Alpha Levels In Serum And Cerebrospinal Fluid For Purulent Meningitis And Viral Meningitis

Objective: To investigate the diagnostic value of serum and cerebrospinal fluid (CSF) levels of C reactive protein (CRP), procalcitonin (PCT) and tumor necrosis factor-alpha (TNF-alpha) for purulent meningitis and viral meningitis. Methods: A total of 147 children with meningitis admitted to The Affiliated Hospital of Southwest Medical University were retrospectively evaluated, including 76 cases of viral meningitis and 71 cases of purulent meningitis. Another 50 children without meningitis within the same period were selected as the control group. The CSF and serum levels of CRP, PCT and TNF-alpha were measured upon admission and during the recovery period, and compared between two groups. Results: On admission, the serum and CSF levels of CRP, PCT and TNF-alpha in the viral meningitis and purulent meningitis groups were significantly higher than those in the control group (P<0.05), while the serum and CSF levels of CRP, PCT and TNF-alpha of patients in the purulent meningitis group were significantly higher than those in the viral meningitis group (P<0.05). The area under the Receiver Operator Characteristic (ROC) curve was 0.958 and 0.921 respectively for combined detection of serum levels of CRP, PCT and TNF-alpha in the diagnosis of purulent meningitis. After treatment, the serum and CSF levels of CRP, PCT and TNF-alpha in viral meningitis and purulent meningitis groups were lower than those before treatment (P<0.05), while no significant difference was noted in serum and CSF levels of CRP, PCT and TNF-alpha between the two meningitis groups (P>0.05). Conclusion: The serum and CSF levels of CRP, PCT and TNF-alpha in children with purulent meningitis are higher than those in children with viral meningitis, and the combined detection of CRP, PCT and TNF-alpha in serum and CSF has certain significance in the differential diagnosis of purulent meningitis and viral meningitis.