Role of serum procalcitonin in monitoring the response to treatment of pediatric meningitis
Abstract
Introduction: A good early diagnostic and prognostic marker for bacterial meningitis will decrease the morbidity and mortality due to this infection. Serum procalcitonin has been evaluated for usefulness in diagnosis and as a prognostic marker in bacterial meningitis.
Methods: Children from 5 months to 15 years of age who were cases of bacterial meningitis as per WHO Criteria and were admitted to the Pediatric Department in SKIMS Srinagar, Jammu, and Kashmir were taken for the study. A total of 45 bacterial meningitis cases participated in this prospective study. Serum PCT was measured by a fluorescence immunoassay using QDX Insta check with a detection limit of 0.25-100 ng/ml. Data were analyzed using standard statistical tests using SPSS 20.
Results: The mean serum PCT on admission in ng/ml in the present study for bacterial meningitis was 14.9293±4.49122 and after 72 hours mean serum PCT was 12.4386±4.40964). A significant drop (mean difference = 2.49086; p=0.000) in serum procalcitonin was seen after 72 hours following antibacterial treatment.
Conclusion: It was concluded that serum PCT can be used as a good prognostic marker to see the response to treatment in bacterial meningitis.
Downloads
References
Sáez-Llorens X, McCracken GH Jr. Bacterial meningitis in neonates and children. Infect Dis Clin North Am. 1990;4(4):623-644.
Neuman HB, Wald ER. Bacterial meningitis in childhood at the Children’s Hospital of Pittsburgh: 1988–1998. Clin Pediatr (Phila). 2001;40 (11):595-600. doi: 10.1177/000992280104001102.
Klein JO, Feigin RD, McCracken GH. Jr. Report of the task force on diagnosis and management of meningitis. Pediatr. 1986;78(5 Pt 2):959-982.
Moreno MT, Vargas S, Poveda R, Sáez-Llorens X. Neonatal sepsis and meningitis in a developing Latin American country. Pediatr Infect Dis J. 1994;13(6):516-520. doi: 10.1097/00006454-199406000-00010.
Sáez-Llorens X, McCracken GJ Jr. Antimicrobial and anti-inflammatory treatment of bacterial meningitis. Infect Dis Clin North Am. 1999;13(3):619-636,vii. doi: 10.1016/s0891-5520(05)70097-0.
Leib SL, Tauber MG. Pathogenesis of bacterial meningitis. Infect Dis Clin North Am. 1999;13(3):527-548. doi: 10.1007/bf01641732.
Sáez-Llorens X, Ramilo O, Mustafa MM, Mertsola J, McCracken GH Jr. Molecular pathophysiology of bacterial meningitis: current concepts and therapeutic implications. J Pediatr. 1990;116(5):671-84. doi: 10.1016/s0022-3476(05)82647-2.
Kaplan S.L. Clinical manifestations, diagnosis, and prognostic factors of bacterial meningitis. Infect Dis Clin North Am. 1999;13(3):579-594, vi-vii. doi: 10.1016/s0891-5520(05)70095-7.
Haruda F.D. Meningitis: viral vs bacterial. Pediatr. 2003;112(2):447-448. doi: 10.1542/peds.112.2.447.
Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis. 2004 Jul 15;39(2):206-17. doi: 10.1086/421997.
Suberviola B, Castellanos-Ortega A, González-Castro A, García-Astudillo LA, Fernández-Miret B. Prognostic value of procalcitonin, C-reactive protein and leukocytes in septic shock. Med Intensiva. 2012;36(3):177-184. doi: 10.1016/j.medin.2011.09.008.
Alavi SM, Shokri S. Can serum procalcitonin measurement help monitor the treatment of acute bacterial meningitis? A prospective study. Caspian J Intern Med. 2012;3(1):382-385.
Ibrahim KA, Abdel-Wahab AA, Ibrahim AS. Diagnostic value of serum procalcitonin levels in children with meningitis: a comparison with blood leukocyte count and C-reactive protein. J Pak Med Assoc. 2011;61(4):346-351.
Viallon A, Guyomarc'h P, Guyomarc'h S, Tardy B, Robert F, Marjollet O, et al. Decrease in serum procalcitonin levels over time during treatment of acute bacterial meningitis. Crit Care. 2005;9(4):R344–R350. doi: 10.1186/cc3722.
Oberhoffer M, Stonans I, Russwurm S, Stonane E, Vogelsang H, Junker U, et al. Procalcitonin expression in human peripheral blood mononuclear cells and its modulation by lipopolysaccharides and sepsis-related cytokines in vitro. J Lab Clin Med. 1999;134(1):49-55. doi: 10.1016/s0022-2143(99)90053-7.
Prat C, Domínguez J, Rodrigo C, Giménez M, Azuara M, Blanco S, et al. Use of quantitative and semiquantitative procalcitonin measurements to identify children with sepsis and meningitis. Eur J Clin Microbiol Infect Dis. 2004;23(2):136-138. doi: 10.1007/s10096-003-1066-4.
Mills GD, Lala HM, Oehley MR, Craig AB, Barratt K, Hood D, et al. Elevated procalcitonin as a diagnostic marker in meningococcal disease. Eur J Clin Microbiol Infect Dis. 2006;25(8):501-509. doi: 10.1007/s10096-006-0179-y.
Gendrel D, Raymond J, Assicot M, Moulin F, Iniguez J, Lebon P, et al. Measurement of procalcitonin levels in children with bacterial or viral meningitis. Clin Infect Dis. 1997;24(6):1240-1242.doi: 10.1086/513633
Schwarz S, Bertram M, Schwab S, Andrassy K, Hacke W. Serum procalcitonin levels in bacterial and abacterial meningitis. Crit Care Med. 2000;28(6):1828-1832. doi: 10.1097/00003246-200006000-00024.
Monneret G, Labaune JM, Isaac C, Bienvenu F, Putet G, Bienvenu J. Procalcitonin and C-reactive protein levels in neonatal infections. Acta Paediatr. 1997;86(2):209-212. doi: 10.1111/j.1651-2227.1997.tb08870.x.
Copyright (c) 2020 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
