ArticleCritical care (London, England)2011
Meningitis in adult patients with a negative direct cerebrospinal fluid examination: value of cytochemical markers for differential diagnosis.
Article in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 4 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Diagnostic accuracy of serum procalcitonin for intracranial infection in adults: A systematic review and meta-analysis.Medicine · 2026Pooled it
- Investigating Blood Biomarkers That Can Facilitate the Diagnosis of Meningitis-A Systematic Literature Review.International journal of molecular sciences · 2025Pooled it
- Diagnostic Accuracy of Procalcitonin in Bacterial Meningitis Versus Nonbacterial Meningitis: A Systematic Review and Meta-Analysis.Medicine · 2016Pooled it
- The use of procalcitonin in the diagnosis of bone and joint infection: a systemic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2013Pooled it
- Methicillin-resistantJournal of surgical case reports · 2026Article
- Serial FDG PET/CT Findings in a Patient With Seronegative Neuroborreliosis After Treatment With Rituximab for a Follicular Lymphoma.Clinical nuclear medicine · 2026Article
- Synovial-to-blood glucose ratio as a biomarker for the early diagnosis of septic arthritis of the knee in emergency medical practice: a retrospective clinical cohort study.BMC musculoskeletal disorders · 2026Article
- Diagnostic Test Accuracy of Serum and Cerebrospinal Fluid C-Reactive Protein in Bacterial Meningitis: A Systematic Review and Meta-Analysis.Infection & chemotherapy · 2025Article
- Cerebrospinal Fluid Analysis in Patients with Post-neurosurgical Procedures: Meningitis vs. Non-meningitis.Iranian journal of pathology · 2024Article
- German guidelines on community-acquired acute bacterial meningitis in adults.Neurological research and practice · 2023Article
- The Diagnostic Value of Cerebrospinal Fluid Lactate for Detection of Sepsis in Community-Acquired Bacterial Meningitis.Diagnostics (Basel, Switzerland) · 2023Article
- Role of cerebrospinal fluid lactate in diagnosing meningitis in critically ill patients.World journal of critical care medicine · 2023Article
- The cerebrospinal fluid neutrophil to lymphocyte ratio is a sensitive biomarker for bacterial meningitis in children.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2022Article
- Neutrophils in Extravascular Body Fluids: Cytological-Energy Analysis Enables Rapid, Reliable and Inexpensive Detection of Purulent Inflammation and Tissue Damage.Life (Basel, Switzerland) · 2022Article
- Procalcitonin measurement in West Nile virus neuroinvasive disease: A first case series.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2021Article
- Development of the Cerebrospinal Fluid in Early Stage after Hemorrhage in the Central Nervous System.Life (Basel, Switzerland) · 2021Article
- Microbial aspects and potential markers for differentiation between bacterial and viral meningitis among adult patients.PloS one · 2021Article
- Bioanalytical Performance of a New Particle-Enhanced Method for Measuring Procalcitonin.Diagnostics (Basel, Switzerland) · 2020Article
- A 2020 review on the role of procalcitonin in different clinical settings: an update conducted with the tools of the Evidence Based Laboratory Medicine.Annals of translational medicine · 2020Review
- Contrast-enhanced modified 3D T1-weighted TSE black-blood imaging can improve detection of infectious and neoplastic meningitis.European radiology · 2020Article
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10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe objective of this study was to determine the ability of various parameters commonly used for the diagnosis of acute meningitis to differentiate between bacterial and viral meningitis, in adult patients with a negative direct cerebrospinal fluid (CSF) examination.
methodsThis was a prospective study, started in 1997, including all patients admitted to the emergency unit with acute meningitis and a negative direct CSF examination. Serum and CSF samples were taken immediately on admission. The patients were divided into two groups according to the type of meningitis: bacterial (BM; group I) or viral (VM; group II). The CSF parameters investigated were cytology, protein, glucose, and lactate; the serum parameters evaluated were C-reactive protein and procalcitonin. CSF/serum glucose and lactate ratios were also assessed.
resultsOf the 254 patients with meningitis with a negative direct CSF examination, 35 had BM and 181, VM. The most highly discriminative parameters for the differential diagnosis of BM proved to be CSF lactate, with a sensitivity of 94%, a specificity of 92%, a negative predictive value of 99%, a positive predictive value of 82% at a diagnostic cut-off level of 3.8 mmol/L (area under the curve (AUC), 0.96; 95% confidence interval (CI), 0.95 to 1), and serum procalcitonin, with a sensitivity of 95%, a specificity of 100%, a negative predictive value of 100%, and a positive predictive value of 97% at a diagnostic cut-off level of 0.28 ng/ml (AUC, 0.99; 95% CI, 0.99 to 1).
conclusionsSerum procalcitonin and CSF lactate concentrations appear to be the most highly discriminative parameters for the differential diagnosis of BM and VM.
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