Abstract

Objective: C-reactive protein(CRP), an acute phase serum globulin, is produced by hepatocytes in response to various nonspecific stimuli such as microbial infection, tissue necrosis, or neoplasm. The aim of this study was to clarify to what extent bacterial meningitis could be distinguished from aseptic or other infectious meningitis through CRP levels in adults. Methods: A total of 113 adult cases(aged 15-98 years), includingpatients with bacterial meningitis(n=14), aseptic meningitis(n=84), and tuberculous(Tb) meningitis(n=15), were retrospectively analyzed based on data from the initial examination. Results: Nine out of 14 patients with bacterial meningitis showed blood CRP levels ≥10mg/dl, whereas CRP levels <10mg/dl were observed in all patients with aseptic or Tb meningitis. Using a CRP level of ≥10mg/dl as a positive discriminatory factor for bacterial meningitis resulted in positive and negative predictive values of 0.91 and 1.0, respectively. To better discriminate bacterial from nonbacterial meningitis, we analyzed changes in CRP and cerebrospinal fluid(CSF) levels using one-way analysis of variance(ANOVA) and concluded that blood CRP is statically significant indicator which is differentiates bacterial meningitis from other meningitis or encephalitis at admission. Conclusion: This study suggests that serum CRP analysis, which is both simple and inexpensive, is helpful to differentiate bacterial meningitis from other aseptic or subacute meningitis.