Research progress of peripheral blood and cerebrospinal fluid detection markers in early diagnosis of purulent meningitis

doi:10.3877/cma.j.issn.2095-655X.2021.02.016

Abstract

Abstract:

Purulent meningitis (PM) is a common neurological infectious disease with low specificity of clinical symptoms in children. If the diagnosis is solely based on clinical symptoms, it may lead to the delay of appropriate antimicrobial therapy. Laboratory tests, including peripheral blood and cerebrospinal fluid (CSF) tests can improve the ability of early diagnosis of PM. Elevated lactate level in CSF, decreased CSF glucose/blood glucose ratio, and positive PCR are independent predictors of PM. However, the laboratory examination results of some children are still atypical, and the test results are even conflict with each other. Therefore, the author mainly summarizes the common peripheral blood and CSF test indicators in the diagnosis of PM, and summarizes the efficacy of each indicator in the diagnosis of PM, so as to guide the early clinical diagnosis.

Key words: Purulent meningitis, Cerebrospinal fluid, CSF glucose/blood glucose ratio, Lactic acid, Child

Rencheng Dou, Yan Lou. Research progress of peripheral blood and cerebrospinal fluid detection markers in early diagnosis of purulent meningitis[J]. Chinese Journal of Diagnostics(Electronic Edition), 2021, 09(02): 137-140.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhzdxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-655X.2021.02.016

https://zhzdxdzzz.cma-cmc.com.cn/EN/Y2021/V09/I02/137

References 37

[1]	van Ettekoven CN, van de Beek D, Brouwer MC. Update on community-acquired bacterial meningitis: guidance and challenges[J]. Clin Microbiol Infect, 2017, 23(9): 601-606.
[2]	Dinleyici M, Iseri Nepesov M, Sipahi OR, et al. The attitudes, behaviors, and knowledge of healthcare professionals towards the diagnosis, treatment, and prevention of bacterial meningitis in Turkey[J]. Hum Vaccin Immunother, 2019, 15(1): 134-140.
[3]	Ray P, Badarou-Acossi G, Viallon A, et al. Accuracy of the cerebrospinal fluid results to differentiate bacterial from non bacterial meningitis, in case of negative gram-stained smear[J]. Am J Emerg Med, 2007, 25(2): 179-184.
[4]	Debray A, Nathanson S, Moulin F, et al.Eosinopenia as a marker of diagnosis and prognostic to distinguish bacterial from aseptic meningitis in pediatrics[J]. Eur J Clin Microbiol Infect Dis, 2019, 38(10): 1821-1827.
[5]	Chalupa P, Beran O, Herwald H, et al. Evaluation of potential biomarkers for the discrimination of bacterial and viral infections[J]. Infection, 2011, 39(5): 411-417.
[6]	Zhang L, Ma L, Zhou X, et al.Diagnostic value of procalcitonin for bacterial meningitis in children: a comparison analysis between serum and cerebrospinal fluid procalcitonin levels[J]. Clin Pediatr (Phila), 2019, 58(2): 159-165.
[7]	Julián-Jiménez A, Candel-González FJ, González Del Castillo J. Usefulness of inflammation and infection biomarkers in the emergency department[J]. Enferm Infecc Microbiol Clin, 2014, 32(3): 177-190.
[8]	Velissaris D, Pintea M, Pantzaris N, et al.The role of procalcitonin in the diagnosis of meningitis: a literature review[J]. J Clin Med, 2018, 7(6): 148.
[9]	Moyes RB, Reynolds J, Breakwell DP. Differential staining of bacteria: gram stain[J]. Curr Protoc Microbiol, 2009: Appendix 3C.
[10]	Thomson J, Sucharew H, Cruz AT, et al. Cerebrospinal fluid reference values for young infants undergoing lumbar puncture[J]. Pediatrics, 2018, 141(3): e20173405..
[11]	Fouad R, Khairy M, Fathalah W, et al.Role of clinical presentations and routine CSF analysis in the rapid diagnosis of acute bacterial meningitis in cases of negative gram stained smears[J]. J Trop Med, 2014(2014): 213762.
[12]	Bosworth A, Bhatt K, Nance A, et al.Elevated lactate levels in the cerebrospinal fluid associated with bacterial meningitis[J]. J Infect, 2019, 79(4): 389-399.
[13]	Kim KS. Investigating bacterial penetration of the blood-brain barrier for the pathogenesis, prevention, and therapy of bacterial meningitis[J]. ACS Infect Dis, 2020, 6(1): 34-42.
[14]	Heckenberg SG, Brouwer MC, van de Beek D. Bacterial meningitis[J]. Handb Clin Neurol, 2014(121): 1361-1375.
[15]	Xu M, Hu L, Huang H, et al.Etiology and clinical features of full-term neonatal bacterial meningitis: a multicenter retrospective cohort study[J]. Front Pediatr, 2019(7): 31.
[16]	赵翠，张澜，程国强．不同病原类型新生儿化脓性脑膜炎临床特点分析[J]．中华新生儿科杂志(中英文)，2018，3(33) ：182-186..
[17]	Julián-Jiménez A, Morales-Casado MI. Usefulness of blood and cerebrospinal fluid laboratory testing to predict bacterial meningitis in the emergency department[J]. Neurologia, 2019, 34(2): 105-113.
[18]	Huy NT, Thao NT, Diep DT, et al. Cerebrospinal fluid lactate concentration to distinguish bacterial from aseptic meningitis: a systemic review and meta-analysis[J]. Crit Care, 2010, 14(6): 240.
[19]	Nazir M, Wani WA, Malik MA, et al.Cerebrospinal fluid lactate: a differential biomarker for bacterial and viral meningitis in children[J]. J Pediatr (Rio J), 2018, 94(1): 88-92.
[20]	de Almeida SM, Furlan SMP, Cretella AMM, et al.Comparison of cerebrospinal fluid biomarkers for differential diagnosis of acute bacterial and viral meningitis with atypical cerebrospinal fluid characteristics[J]. Med Princ Pract, 2020, 29(3): 244-254.
[21]	Brouwer MC, Thwaites GE, Tunkel AR, et al. Dilemmas in the diagnosis of acute community-acquired bacterial meningitis[J]. Lancet, 2012, 380(9854): 1684-1692.
[22]	Rousseau G, Asmolov R, Grammatico-Guillon L, et al.Rapid detection of bacterial meningitis using a point-of-care glucometer[J]. Eur J Emerg Med, 2019, 26(1): 41-46.
[23]	冯绵烨，娄燕．病毒性脑炎的诊治研究进展[J/CD]．中华诊断学电子杂志，2019，7(1): 66-70.
[24]	Abdeldaim GM, Stralin K, Korsgaard J, et al.Multiplex quantitative PCR for detection of lower respiratory tract infection and meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis[J]. BMC Microbiol, 2010(10): 310.
[25]	Albuquerque RC, Moreno ACR, Dos Santos SR, et al.Multiplex-PCR for diagnosis of bacterial meningitis[J]. Braz J Microbiol, 2019, 50(2): 435-443.
[26]	Liesman RM, Strasburg AP, Heitman AK, et al.Evaluation of a commercial multiplex molecular panel for diagnosis of infectious meningitis and encephalitis[J]. J Clin Microbiol, 2018, 56(4): e01927-17.
[27]	Kocsis B, Tiszlavicz Z, Jakab G, et al.Case report of Actinomyces turicensis meningitis as a complication of purulent mastoiditis[J]. BMC Infect Dis, 2018, 18(1): 686.
[28]	Corless CE, Guiver M, Borrow R, et al.Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in suspected cases of meningitis and septicemia using real-time PCR[J]. J Clin Microbiol, 2001, 39(4): 1553-1558.
[29]	Wagner K, Springer B, Pires VP, et al.Pathogen identification by multiplex light mix real-time PCR assay in patients with meningitis and culture-negative cerebrospinal fluid specimens[J]. J Clin Microbiol, 2018, 56(2): e01927-17..
[30]	Zhang XX, Guo LY, Liu LL, et al. The diagnostic value of metagenomic next-generation sequencing for identifying Streptococcus pneumoniae in paediatric bacterial meningitis[J]. BMC Infect Dis, 2019, 19(1): 495.
[31]	Guo LY, Li YJ, Liu LL, et al. Detection of pediatric bacterial meningitis pathogens from cerebrospinal fluid by next-generation sequencing technology[J]. J Infect, 2019, 78(4): 323-337.
[32]	Zhang G, Zheng G, Zhang Y, et al.Evaluation of a micro/nanofluidic chip platform for the high-throughput detection of bacteria and their antibiotic resistance genes in post-neurosurgical meningitis[J]. Int J Infect Dis, 2018(70): 115-120.
[33]	Liu Q, Gao Y, Zhang B, et al.Cytokine profiles in cerebrospinal fluid of patients with meningitis at a tertiary general hospital in China[J]. J Microbiol Immunol Infect, 2020, 53(2): 216-224.
[34]	Hu R, Gong Y, Wang Y. Relationship of serum procalcitonin levels to severity and prognosis in pediatric bacterial meningitis[J]. Clin Pediatr (Phila), 2015, 54(12): 1141-1144.
[35]	Henry BM, Roy J, Ramakrishnan PK, et al. Procalcitonin as a serum biomarker for differentiation of bacterial meningitis from viral meningitis in children: evidence from a meta-analysis[J]. Clin Pediatr (Phila), 2016, 55(8): 749-764.
[36]	Chen H, Wu F, Fu R, et al.Expression of MMP-2 and TIMP-1 in cerebrospinal fluid and the correlation with dynamic changes of serum PCT in neonatal purulent meningitis[J]. Exp Ther Med, 2018, 15(2): 1285-1288.
[37]	Vazquez JA, Taha MK, Findlow J, et al. Global Meningococcal Initiative: guidelines for diagnosis and confirmation of invasive meningococcal disease[J]. Epidemiol Infect, 2016, 144(14): 3052-3057.

Please choose a citation manager

Content to export