BACKGROUND AND OBJECTIVE

Accurately diagnosing bacterial meningitis and ventriculitis in children is challenging due to nonspecific symptoms and the lack of specificity in conventional CSF parameters. Cerebrospinal fluid (CSF) procalcitonin (PCT) is a promising diagnostic marker but studies on its utility in children are lacking. We aimed to assess the diagnostic value of CSF procalcitonin for bacterial meningitis and ventriculitis in children and establish a clinically relevant cut-off level.

METHODS

A total of 131 patients were included in the study, and the CSF PCT levels were measured in two groups. Group 1 comprised of patients with bacterial meningitis and ventriculitis (n=21), while Group 2 consisted of patients with tuberculous meningitis, fungal meningitis, viral encephalitis, autoimmune encephalitis, central nervous system (CNS) leukemia, and non-infectious or inflammatory CNS conditions (n=110).

RESULTS

CSF PCT demonstrated an area under the curve of 96.57% in the receiver operating characteristic analysis. With a cut-off of 0.19 ng/mL, it achieved high sensitivity (90.48%) and specificity (91.82%), making it an excellent test for distinguishing between bacterial meningitis and ventriculitis from control diseases.

CONCLUSION

CSF procalcitonin is highly effective in distinguishing pediatric bacterial meningitis and ventriculitis. Especially in clinical scenarios where the conventional laboratory tests are inconclusive, it can complement clinical assessment to diagnose CNS infections accurately and guide prudent antibiotic use.

Human ; Meningitis, Bacterial

BACKGROUND AND OBJECTIVE: Japanese Encephalitis (JE) is an acute encephalomyelitis characterized by abrupt fulminant illness with fever, convulsions, signs of increased intracranial pressure and focal neurologic sings. It is major cause of viral encephalitis in Asia. The exact prevalence is difficult to determine especially in a developing country like the Philippines where specific tests like the Japanese Encephalitis Virus IgM, is costly and not readily available in all medical center laboratories.

CASE SERIES: The 4 pediatric confirmed cases of Japanese Encephalitis who all initially presented with fever, seizures and behavioral changes. All of them had a history of travel to endemic areas of JE in the Philippines. Japanese virus ELISA test IgM showed positive results in all patients. Cranial CT scans showed predilection of involvement in the areas of the thalamus, basal ganglia and the brainstem. All of the patients survived but had significant neurologic deficits on discharge.

Encephalitis Japanese ; Encephalitis ; Encephalitis, Viral ; Encephalitis, Arbovirus ; Pediatrics

This is a case report of a retained placenta which was successfully removed using nitroglycerin spray.
Human ; Female ; Adult ; PLACENTA, RETAINED ; ANESTHESIA ; ANESTHESIA, CONDUCTION ; NITROGLYCERIN ; ; ;