Epidemiological study of Meningitis and Role of Neopterin in its Diagnosis

Abstract

Background: Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs. Neopterin alone or even better in combinations with C-reactive protein is very well suited to support the differential diagnosis of viral versus bacterial infections. Aim: The study aimed at determination of epidemiological profile of all admitted cases of meningitis in the age group (Two to twelve years old) and to evaluate the potential role of serum neopterin level in differentiation between septic & aseptic meningitis. Patients & Methods: Nignty meningitis cases admitted in Imbabah Fever Hospital in one year (May/2012-May/2013) and eighty one meningitis cases admitted in a period of 1 year (May/2013-May /2014). The following had been done for all patients: Full medical history and Clinical examination, Laboratory investigation including: CBC, Serum neopterin by ELISA of the second groups and CSF analysis. Statistical analysis the data were coded, entered and processed on computer using SPSS. Results: risk factors among cases of meningitis are age <5 years, males more affected(63.3%)in the 1st group in comparison to the 2nd groups(56.8%), there was a statistical significant difference as regard contact to ill relative with a higher percent in the 1st groups 66.2% in comparison to the 2nd groups 33.8%. There was a higher percent of viral meningitis in the 2nd groups (67.9%) in comparison to the 1st (47.8%). CSF culture: no growth (there was higher percent in 1st groups 32.2% in comparison to the 2nd groups 14.8%), followed by St. pneumonia (there was a higher percent in the 2nd groups 9.9% in comparison to the 1st groups 5.6%), then H influenza (there was a higher percent in the 1st groups 7.8% in comparison to the 2nd groups 2.5%) , the lowest percentage was TB meningitis with a percent of 1% and 0% in 1st and 2nd groups respectively. There was positive correlation between the bacterial meningitis occurrence and the higher level of serum neopetrin. Conclusion: Meningitis is a common childhood illness, its incidence is increasing worldwide in an alarming rate and it has neurological sequalae that affects the growth and development of children and all aspects of their life. Neopterin is a rapid diagnostic marker to differentiate between viral and bacterial infections. _______________________________ Key words: epidemiological study, aseptic meningitis, acute meningitis, chronic meningitis and neopterin.