Despite the fact that the prognosis of
bacterial meningitis has been improved by the influence of
antibiotics, this disease is still one of the significant causes of morbidity and mortality in children. Rapid differentiation between bacterial and
aseptic meningitis, and the need for immediate
antibiotic treatment in the former, is crucial in the prognosis of these patients.
Ferritin is one of the most sensitive
biochemical markers investigated in cerebrospinal fluid (CSF) for the early diagnosis of
bacterial meningitis. The present study aims to evaluate the diagnostic capability of CSF
ferritin in differentiating bacterial and
viral meningitis in the paediatric setting. A cross-sectional study was carried out in the referral Children's Medical Center Hospital, Tehran, during 2008 and 2009. According to the inclusion criteria, CSF samples from 42 patients with suspected
meningitis were obtained and divided into two
meningitis groups, bacterial (n = 18) and viral (n = 24).
Ferritin and other routine determinants (i.e., leucocytes,
protein and
glucose) were compared between the two groups.
Ferritin concentration in the
bacterial meningitis group was 106.39 +/- 86.96 ng/dL, which was considerably higher than in the
viral meningitis group (10.17 +/- 14.09, P < 0.001). Mean CSF
protein concentration and cell count were significantly higher in the
bacterial meningitis group and showed a positive correlation with CSF
ferritin. In conclusion, this study suggests that CSF
ferritin concentration is an accurate test for the early differentiation of bacterial and
aseptic meningitis; however, further investigation on a larger cohort of patients is required to confirm this finding.