Evaluation of cerebrospinal fluid viscosity as a novel diagnostic measure for acute meningitis

Abstract number: P1761

Yetkin F., Kayabas U., Ersoy Y., Bayindir Y., Altunisik Toplu S., Tek I.

Objectives:In this study we aimed to evaluate the role of CSF viscosity as complemantary measure for diagnosis of meningitis in suspected patients.

Methods: Forty one consecutive patients who undergone lumbar puncture to rule out meningitis were included in the study. The cases were further categorized into two subgroups: (i) the bacterial meningitis group, whose CSF culture yielded one or more known causative bacteria; and (ii) the aseptic meningitis group, comprising those with negative CSF and blood cultures and recovery without more than 4 days of antibiotic treatment. In the remaining 14 patients diagnosis of meningitis was ruled out. A blood or CSF sample was also placed into a tube containing ethylenediaminetetra-acetic acid (EDTA) anticoagulant for viscosity analysis. Measurements of CSF and plasma viscosity were performed using Brook-field DV-II viscometer (Brookfield, Stoughton, MA, USA).

Results: Among the 41 patients included in the study, 27 patients were diagnosed as meningitis. Of whom 13 patients were aseptic meningitis, 14 patients were bacterial meningitis. Causative agents in bacterial meningitis were found to be Streptococcus pneumoniae in 10 (71%) patients, Neisseria meningitidis in 2 (14%) patients, Streptococcus pyogenes in 1 (7%) patients and Acinetobacter spp in 1 (7%) patient. Meningitis was ruled out in 14 patients. CSF protein and CSF viscosity were significantly higher in patients with meningitis compared to non meningitis(Table 1). ROC analysis revealed that CSF viscosity was highly sensitive (100%) and specific (93%) measure for the diagnosis of meningitis in the study population and was comparable to those of CSF protein. Although specificity of plasma viscosity is comparable with CSF protein and viscosity, sensitivity of plasma viscosity was significantly lower than those of CSF protein and viscosity. Additionally patients with meningitis were also divided into two subgroups as having bacterial and aseptic meningitis. CSF viscosity also significantly differed between bacterial and aseptic meningitis.

Conclusion: Although the sensitivity and specificity of the CSF viscosity is comparable to those of CSF protein, CSF viscosity which is a simple and easy method can be used as an adjunctive measure for the diagnosis of meningitis. With the support of further and larger clinical studies CSF viscosity may have a role in the discrimination of bacterial versus aseptic meningitis.

Table 1. Baseline characteristics of patients and cerebrospinal fluid analysis of patients

 Patients without meningitisPatients with meningitisP value
Age (year)49±1942±150.19
Gender (female)54%32%0.19
White blood cell/mm39520±443114190±73520.058
Erythrocyte sedimentation rate (mm/h)27±2755±340.006
C-reactive protein (mg/dL)29±32120±1020.005
Plasma viscosity (mpa·s)1.23±0.061.33±0.100.002
Cerebrospinal fluid
  Protein (mg/dL)33.3±10218±177<0.001
  Glucose (mg/dL)86±3750±400.001
  CSF viscosity (mpa·s)0.72±0.0180.84±0.08<0.001
CSF: Cerebrospinal Fluid.

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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