ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2016
Neutrophil-to-lymphocyte ratio in the differential diagnosis of acute bacterial meningitis.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Investigating Blood Biomarkers That Can Facilitate the Diagnosis of Meningitis-A Systematic Literature Review.International journal of molecular sciences · 2025Pooled it
- The Clinical Utility of Serum Biomarkers in the Differentiation and Prognostic Assessment of Viral Meningitis.Pathogens (Basel, Switzerland) · 2026Article
- Neutrophil to Lymphocyte Ratio in Patients With a First Episode of Psychosis: A Two-Year Longitudinal Follow-up Study.Schizophrenia bulletin · 2022Article
- Evaluation of the blood neutrophil-to-lymphocyte ratio as a biomarker for meningoencephalitis of unknown etiology in dogs.Journal of veterinary internal medicine · 2022Article
- Determining an infectious or autoimmune etiology in encephalitis.Annals of clinical and translational neurology · 2022Article
- Neutrophil-lymphocyte ratio as a potential marker for differential diagnosis between spinal tuberculosis and pyogenic spinal infection.Journal of orthopaedic surgery and research · 2022Article
- 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
- Diagnostic accuracy of complete blood cell count and neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and platelet-to-lymphocyte ratios for neonatal infection.Asian biomedicine : research, reviews and news · 2022Article
- Neutrophil lymphocyte ratio as predictor of mortality in pediatric patients with bacterial meningitis: A retrospective cohort study.Annals of medicine and surgery (2012) · 2022Article
- Neutrophil-to-lymphocyte ratio is associated with increased cerebral blood flow velocity in acute bacterial meningitis.Scientific reports · 2021Article
- Artificial Intelligence in Differential Diagnostics of Meningitis: A Nationwide Study.Diagnostics (Basel, Switzerland) · 2021Article
- NLRP3 in the Cerebrospinal Fluid as a Potential Biomarker for the Diagnosis and Prognosis of Community-Acquired Bacterial Meningitis in Adults.Frontiers in cellular and infection microbiology · 2021Article
- Neutrophil NETworking in ENL: Potential as a Putative Biomarker: Future Insights.Frontiers in medicine · 2021Review
- Diagnostic value of neutrophil-to-lymphocyte ratio in patients with leprosy reactions.Heliyon · 2020Article
- Age-specific application of neutrophil-to-lymphocyte ratio in meningitis: a nationwide study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Article
- Role of neutrophil to lymphocyte and monocyte to lymphocyte ratios in the diagnosis of bacterial infection in patients with fever.Infection · 2017Article
- CSF in acute and chronic infectious diseases.Handbook of clinical neurology · 2017Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The differential diagnosis of acute community-acquired meningitis is of paramount importance in both therapeutic and healthcare-related economic terms. Despite the routinely used markers, novel, easily calculated, and rapidly available biomarkers are needed particularly in resource-poor settings. A promising, exponentially studied inflammatory marker is the neutrophil-to-lymphocyte ratio (NLR), albeit not assessed in meningitis. The aim of this study was to investigate the utility of the NLR in the differential diagnosis of acute meningitis. Data on cerebrospinal fluid (CSF) and blood leukocyte parameters from more than 4,000 patients diagnosed with either bacterial or viral meningitis in Greece during the period 2006-2013 were retrospectively examined. The diagnostic accuracy of the NLR and neutrophil counts in CSF and blood were evaluated by receiver operating characteristic curves. The discrimination ability of both the NLR and neutrophil counts was significantly higher in CSF than in blood. The optimal cutoff values of the NLR and neutrophil counts were 2 in CSF vs 8 in blood, and 287 cells in CSF vs 12,100 cells in blood, respectively. For these values, sensitivity, negative predictive value, and odds ratio were statistically significantly higher in CSF than blood for both markers. Logistic regression analysis showed that the CSF NLR carries independent and additive information to neutrophil counts in the differential diagnosis of acute meningitis. This study is the first one to assess NLR in acute meningitis, providing promising results for its differential diagnosis.
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