The Diagnostic Value Of Procalcitonin Level For Intracranial Infection

Background and Objective:This study was to evaluate evaluate the diagnostic value of PCT level for intracranial infection detecting serum and CSF PCT level of intracranial infection patients and healthy persons.Patients and Method:The 68 patients of intracranial infection who came to the Department of Neurology of the First Norman Bethune Hospital of Jilin University were collected from May 2015 to January 2016. They were divided into three experimental groups:22 patients with purulent meningitis, 28 with virus meningitis and 18 with tubercular meningitis. Then we chose 25 patients without intracranial infection from Lumbar Puncture Room of out-patient department as the control group. The age and gender composition among experimental groups and the control group showed no statistical difference. All of the patients had taken the examinations of serum and CSF PCT,blood routine, CSF routine and CSF microbiology examination. All statistical analysis was performed with Graphpad Prism 6.0 and Microsoft Excel 2016.Results:1. The patients with purulent meningitis had higher serum and CSF PCT level than those with tubercular or virus meningitis and the control group(P<0.01). The patients with tubercular meningitis had higher serum PCT level than those with virus meningitis and the control group(P<0.01), the patients with tubercular meningitis had higher CSF PCT level than the healthy group(P<0.05).2. In the diagnosis of purulent meningitis, the cut-off of serum PCT was0.38ng/ml, the sensitivity and specificity was both 100% and AUC was 0.97; the cutoff of CSF PCT was 0.15ng/ml, the sensitivity and specificity was 86.36% and 92%and AUC was 0.946: Serum and CSF PCT has the best diagnostic value. In the diagnosis of tubercular meningitis, the cut-off of serum PCT was 0.155ng/ml, the sensitivity and specificity was both 61.11% and 100% and AUC was 0.734; the cutoff of CSF PCT was 0.105ng/ml, the sensitivity and specificity was 77.78% and 88%and AUC was 0.769: serum and CSF PCT has a moderate diagnostic value. In the diagnosis of virus meningitis, AUC of serum and CSF PCT was 0.557 and 0.546, PCT has no diagnostic value for virus meningitis.3. Serum and CSF PCT had the best diagnostic value in distinguishing purulent meningitis and virus meningitis. Serum PCT had the best diagnostic value in distinguishing purulent meningitis and tubercular meningitis and CSF PCT had a better diagnostic value. Serum and CSF PCT had a moderate diagnostic value in distinguishing tubercular meningitis and virus meningitis.Conclusion:1.Serum and CSF PCT level are both significantly high in patients with purulent meningitis. With high sensitivity and specificity, PCT has the best value in the diagnosis of purulent meningitis and can be used for early diagnosis.2.Serum PCT is significantly raised in patients with tubercular meningitis while the raise of CSF PCT level is observed but not significant. Serum and CSF PCT have moderate value in the diagnosis of tubercular meningitis. PCT level together with other testing means is helpful for early diagnosis of tubercular meningitis and differential diagnosis.3.Serum and CSF PCT show no raise in viral meningitis.4.Serum and CSF PCT can effectively identify purulent meningitis and tubercular meningitis or virus meningitis.