A STUDY OF CEREBROSPINAL FLUID, C-REACTIVE PROTEIN AND ADENOSINE DEAMINASE LEVELS IN MENINGITIS IN ADULTS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 27
Abstract
BACKGROUND Infectious disease remains a major cause of death and disability for millions around the world, in spite of progress in many antibiotics and preventive strategies. Even though, CNS is protected by blood brain barrier, a system of tight junction around capillaries fail to resist the entry of microorganisms at times. Its presence, prevents the achievement of sufficient concentration of antibiotics in CSF. CNS infections can cause devastating sequelae, and in some cases, it can present as neurological or medical emergencies. MATERIALS AND METHODS CSF samples were obtained from 50 patients of clinically suspected cases of meningitis who are admitted in Medicine Department of Government General Hospital, Kakinada, during the period from October 2013 and September 2016. A sample size of 50 patient were included in the study. RESULTS CRP levels were elevated in pyogenic meningitis. The mean CRP level in our study was 30.2 ± 5.22 mg/dL. The patients with tuberculous and viral meningitis had a mean CRP level of 2.37 ± 4.79 mg/dL and 1.17 ± 0.31 mg/dL, respectively. In our study, we had high values of ADA in TBM with a mean of 14.17 ± 11.2 U/L. In pyogenic meningitis, it was 3.4 ± 3.03 U/L, and in viral meningitis, it was 1.96 ± 0.99 U/L. Higher cutoff values for ADA helped in separating the overlapped cases of pyogenic and TBM. CONCLUSION As in previous studies, it is apparent from the results of our study that the level of ADA in CSF was considerably elevated in TBM compared with viral meningitis. This conclusion has proved to be extremely beneficial in the treatment of viral meningitis where patients have been started inadvertently on prolonged courses of antitubercular medication with the misdiagnosis of tubercular meningitis. We found that the ADA levels correlated with the severity of clinical presentation. Patients who presented with altered sensorium, cranial nerve involvement and hemiparesis were noted to have higher ADA values. However, there was no clear correlation with the outcome. One fatal case of tubercular meningitis had an ADA of 52 U/L (although, few patients with a mild elevation above the cut-off value have also died).
Authors and Affiliations
Katragadda Suneetha, Vijaya Kumar H
Keywords
Related Articles
- EP ID EP217732
- DOI 10.18410/jebmh/2017/310
- Views 76
- Downloads 0
AUTOPSY-BASED STUDY OF SILENT LIVER DISEASES IN MEDICOLEGAL CASES IN A TERTIARY CARE CENTRE OF EASTERN ODISHA
BACKGROUND An autopsy is a medical procedure that consists of a thorough examination of corpse to determine the cause of death and to evaluate any diseases that maybe present. Most of the chronic liver diseases even in a...
PEDICLED ANTEROLATERAL THIGH FLAP AS A COVER FOR RECONSTRUCTION OF POST FOURNIER’S GANGRENE SCROTAL DEFECTS
BACKGROUND Fournier’s gangrene is an acute and potentially lethal necrotizing fasciitis that involves the scrotum and perineum. This disease can result in the extensive loss of skin and soft tissues of the perineoscrotal...
MODIFIED CERVICAL APPROACH FOR SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK
BACKGROUND There have been several studies on cervical approach for supraclavicular brachial plexus block. It is given in the apical area between the medial and lateral heads of sternocleidomastoid muscle. The technique...
EFFICACY, SAFETY AND QUALITY OF LIFE OUTCOMES OF PALONOSETRON, RAMOSETRON AND GRANISETRON AS A PART OF ANTIEMETIC THERAPY IN PREVENTION OF CHEMOTHERAPY INDUCED NAUSEA AND VOMITING- A RANDOMISED COMPARATIVE TRIAL
BACKGROUND 5-HT3 receptor antagonists have potent antiemetic effect in chemotherapy induced nausea and vomiting. The present study was conducted to study and compare the efficacy and safety of ramosetron, palonosetron an...
PANCREATOBLASTOMA- A CASE REPORT
CASE PRESENTATION A 3-year-old male child referred to the radiology department with complaints as explained by parents - loss of appetite & loss of body weight since 6 months, feeling of mass in upper abdomen since 1 mon...