VALUE OF CEREBROSPINAL FLUID FERRITIN LEVEL FOR DIFFERENTIATION BETWEEN ASEPTIC AND BACTERIAL MENINGITIS IN ADULTS

Abstract

At the time being there is no clinical or laboratory diagnostic method which can solely prove or disprove bacterial meningitis instantly and accurately in patients with pleocytosis in cerebrospinal fluid and the most methods used for diagnosing bacterial meningitis are associated with serious limitations. It is important to distinguish bacterial meningitis from aseptic meningitis during the acute phase of the disease, when clinical symptoms are often similar, this could help to avoid complications and to limit unnecessary antibiotic use. Considering the role of CSF ferritin on differentiation of septic from aseptic meningitis and the importance of early diagnosis of bacterial meningitis especially for patients who have been treated partially by antibiotics, this study aimed for earlier diagnosis and differentiation of bacterial from aseptic meningitis by evaluation of CSF ferritin levels on patients presenting neurological findings match with meningitis in order to start antibiotic therapy as soon as possible. The current study included 90 patients who were diagnosed as acute meningitis with exclusion of patients with these criteria: clinical picture suggestive of cerebro-vascular disease, brain tumors or other neurological insults, tuberculous meningitis, other causes of fever (presence of another site of infection), other  causes of coma, drug-induced meningeal irritation as intravenous immuno-globulins, azathioprine, methotrexate…etc. d