الفهرس 
Anatomy and physiologyOnly 14 pages are availabe for public view
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Abstract
Septic meningitis is a life threatening disease, which requires rapid and
accurate diagnosis and prompt treatment if disabiliting sequelae are to
be minimized. On the other hand, aseptic meningitis in most cases is a
self limited disease which usually require symptomatic treatment.
Whether it is septic or aseptic is the critical question in meningitis.
Many tests have been designed to answer this question. However, most
of them are too complicated to be available in the emergency situations
especially in the developing countries. Also, the overlop between
biochemical and cytological analyses in different types of meningitis
poses a continuous problem for the clinician in charge of the patient..
The aim in this study was to look at the reliability of serum C.R.P. in :
l-Differential diagnosis between septic and aseptic meningits.
2-Differentiation between complicated and non complicated cases of
septic meningitis.
3- Early detection and follow up of complications in cases of septic
meningitis .
In this study 45 cases of meningitis (selected from 180 cases with
C.N.S. infections) were included.
Every cases was subjected to the following :
1) Cmplete hisory taking and complete clinical examinations.
2) Blood examinations.
3) C.S.F. examinations.
4) Follow up by serial serum C.R.P. determinations.
The 45 cases were divided into two main groups:
(l) GrolLp one:
Included 15 patients with aseptic meningitis.
(2.1Grollp two:
Included 30 patients with septic meningitis.
Group two was further subdivided into two subgroups :
a) Subgroup (a) which were non complicated cases and included 19
cases
b) Subgroup (b) which were complicated cases and included 11
cases.
CRP. was determined two times on the average for patients with a
septic meningitis( one on admission and another on discharge) And
seven times on the average for patients with septic meningitis(from
admission until discharge every other day).
In this study we found that:
I-By clinical examinations we can strongly suggest meningitis but we
can not differentiate between septic and aseptic meningitis.
2-Blood examinations including white blood cell count and blood
culture (and not blood glucose) were significant in differential
diagnosis between septic and aseptic meningitis. However, they need
time, cost and an experience more than that required for C.R.P.
determination.
3-C.S.F. examinations including , aspect, protein, glucose and
culture(and not C.S.F. tension) were significant in differential
diagnosis between septic and asptic meningitis. However, they need
time, cost and an experience more than that required for C.R.P.
determination.
4-Serum C.R.P. determination was proved to be:
i) Highly significant in the differential diagnosis between septic and
aseptic meningitis.
ii) Highly significant in the differential diagnosis between aseptic
meningitis and partially treated septic meningitis before admission to
the hospital.
iii) Significant in differentiation between complicated and non
complicated cases of septic meningitis.
iiii) a cheap, rapid, simple and easy to be performed in poor districts
with limited laboratory resources.
RECOMMENDA110NS
According to our study we should minded by :
l-Meningitis must be considered as a serious life threatening disease.
2-The clinical criteria for diagnosis of meningitis must be in the mind
of every clinician especially who are in contact with patients living in
poor districts
3-C.R.P. is a cheap, reliable, rapid, simple test and easy to be
performed which must be a vailable and done for meningitis patients
especially in districts with limited laboratory resources.
4-We must establish a program for early diagnosis and management of
meningitis especially neonatal meningitis.