Confirmation Of Clinically Suspected Cases Of Meningococcal Meningitis By Polymerase Chain Reaction (PCR

Abstract

Bacterial meningitis remains an important cause of morbidity and mortality despite substantial progress m diagnosis and treatment.

Acute bacterial meningitis has a world-wide distribution. The commonest causes of bacterial meningitis throughout both the wet and dry tropics are streptococcus pneumoniae and Haemophilus injluenzae. Meningococcal infection is most common in the northern Subsaham belt of tropical Africa (meningitis belt), where major epidemics occur.

The traditional diagnostic methods as Gram staining and culture have, for may years, provided the clinicians with assistance in the diagnosis of bacterial meningitis. Despite that an early correct diagnosis may be obtained by visualization of Gram-stained bacteria on microscopic examination of CSF deposit, this way may be difficult even in experienced hand and requires intact bacterial morphology. Cultural methods may take up to 48-72 hours for identification of the organisms and bacteria must be viable.

In addition, Gram-stained smear and culture may fail to prove the aetiology in patients already treated with antibiotics. Hence rapid tests for identification of bacterial antigens has been developed. These tests include counter immuno­ electrophoresis, enzyme-linked immunosorbant assay, co­ agglutination and latex agglutination tests.