Serum Procalcitonin Level and Other Biological Markers to Distinguish Between Bacterial and Aseptic Meningitis in Children

Results:Of198patientsanalyzed,96hadbacterialmeningitis. Sensitivity of cerebrospinal fluid Gram staining was 75%. The PCT level had significantly better results than the other markers for area under the receiver operating characteristic curve (0.98; 95% confidence interval, 0.95-0.99; P=.001). At a 0.5-ng/mL threshold, PCT levelhad99%sensitivity(95%confidenceinterval,97%100%)and83%specificity(95%confidenceinterval,76%90%) for distinguishing between bacterial and aseptic meningitis. The diagnostic odds ratio between high PCT level and bacterial meningitis was 139 (95% confidence interval, 39-498), without significant heterogeneity between centers. Conclusions:ThePCTlevelisastrongpredictorfordistinguishing between bacterial and aseptic meningitis in children in the emergency department. Its combination withotherparametersinaneffectiveclinicaldecisionrule could be helpful.