AbstractBackground: In developing countries despite advances in antibiotic therapy Bacterialmeningitis remains a significant cause of morbidity and mortality. It is commonly diagnosedon basis of clinical presentation and cerebrospinal fluid analysis (CSF). But at times atypicalCSF findings are encountered over cases of clinically suspected bacterial meningitis andsometimes due to prior antibiotic use, which puts the treating physician in dilemma regardinginitiation of antibiotics. Therefore, an early and a confirmed diagnosis is required formanaging such cases and to achieve a favorable outcome. Various studies suggestProcalcitonin to be a promising biomarker for diagnosing bacterial infections. But there arealso studies which suggest serum procalcitonin and CSF procalcitonin to be a superior biomarkers in differentiating Bacterial from another non-bacterial meningitis. Therefore, thisstudy is undertaken to find out a biochemical marker to diagnose Bacterial meningitis withincreased accuracy which will help the clinicians to differentiate Bacterial meningitis fromother common infective meningitis, for proper therapeutic decisions with the followingobjectivesAim: A comparative study of cerebrospinal fluid Procalcitonin and serum procalcitonin inpatients with bacterial meningitis.Material and Method: This observational and analytical study was carried out in theDepartment of General Medicine, among patients admitted under Department of GeneralMedicine and Department of Neurology with a sample size of 60 following inclusion andexclusion criteria. The subjects were evaluated, data collected, blood samples were sent forroutine investigations and Lumbar puncture was done in favorable subjects. The CSF analysiswas done along with serum and CSF procalcitonin. The test for CSF and Serum procalcitoninwere conducted using a Sandwich immunodetection method using ichroma PCT analyzer.The results were analysed using appropriate statistical methods.Results: In our study it was observed that the elderly age group has a higher association withmeningitis. The occurrence of Bacterial meningitis shows a significant seasonal pattern,mostly during winter. Subjects of bacterial meningitis has the longest duration of hospitalstay. The predictive value of both serum and CSF procalcitonin are higher in cases ofBacterial meningitis in comparison to non-bacterial meningitis. The ROC analysis concludedthat the diagnostic accuracy of CSF procalcitonin is slightly higher but statistically notsignificant in diagnosing Bacterial meningitis. The Cerebrospinal fluid and Serumprocalcitonin were not significant in cases of Viral meningitis and Tubercular meningitismaking it a poor biomarker in this meningitis. Conclusion: Both serum and CSF procalcitonin are better markers in diagnosing Bacterialmeningitis and to differentiate them from another non-bacterial meningitis. The study wasconducted in context of high morbidity and mortality of Bacterial meningitis and associatedcomplications and the need for a better bio-marker in early diagnosis of Bacterial meningitisand initiation of prompt and proper treatment. The data was analyzed and observations werediscussed along with relevant contemporary literature and other studies. Further researchworks needs to be done on combined use of Serum as well as CSF procalcitonin in cases ofBacterial meningitis.

AbstractBackground: In developing countries despite advances in antibiotic therapy Bacterialmeningitis remains a significant cause of morbidity and mortality. It is commonly diagnosedon basis of clinical presentation and cerebrospinal fluid analysis (CSF). But at times atypicalCSF findings are encountered over cases of clinically suspected bacterial meningitis andsometimes due to prior antibiotic use, which puts the treating physician in dilemma regardinginitiation of antibiotics. Therefore, an early and a confirmed diagnosis is required formanaging such cases and to achieve a favorable outcome. Various studies suggestProcalcitonin to be a promising biomarker for diagnosing bacterial infections. But there arealso studies which suggest serum procalcitonin and CSF procalcitonin to be a superior biomarkers in differentiating Bacterial from another non-bacterial meningitis. Therefore, thisstudy is undertaken to find out a biochemical marker to diagnose Bacterial meningitis withincreased accuracy which will help the clinicians to differentiate Bacterial meningitis fromother common infective meningitis, for proper therapeutic decisions with the followingobjectivesAim: A comparative study of cerebrospinal fluid Procalcitonin and serum procalcitonin inpatients with bacterial meningitis.Material and Method: This observational and analytical study was carried out in theDepartment of General Medicine, among patients admitted under Department of GeneralMedicine and Department of Neurology with a sample size of 60 following inclusion andexclusion criteria. The subjects were evaluated, data collected, blood samples were sent forroutine investigations and Lumbar puncture was done in favorable subjects. The CSF analysiswas done along with serum and CSF procalcitonin. The test for CSF and Serum procalcitoninwere conducted using a Sandwich immunodetection method using ichroma PCT analyzer.The results were analysed using appropriate statistical methods.Results: In our study it was observed that the elderly age group has a higher association withmeningitis. The occurrence of Bacterial meningitis shows a significant seasonal pattern,mostly during winter. Subjects of bacterial meningitis has the longest duration of hospitalstay. The predictive value of both serum and CSF procalcitonin are higher in cases ofBacterial meningitis in comparison to non-bacterial meningitis. The ROC analysis concludedthat the diagnostic accuracy of CSF procalcitonin is slightly higher but statistically notsignificant in diagnosing Bacterial meningitis. The Cerebrospinal fluid and Serumprocalcitonin were not significant in cases of Viral meningitis and Tubercular meningitismaking it a poor biomarker in this meningitis.Conclusion: Both serum and CSF procalcitonin are better markers in diagnosing Bacterialmeningitis and to differentiate them from another non-bacterial meningitis. The study wasconducted in context of high morbidity and mortality of Bacterial meningitis and associatedcomplications and the need for a better bio-marker in early diagnosis of Bacterial meningitisand initiation of prompt and proper treatment. The data was analyzed and observations werediscussed along with relevant contemporary literature and other studies. Further researchworks needs to be done on combined use of Serum as well as CSF procalcitonin in cases ofBacterial meningitis.