J Clin Neurol.  2016 Jul;12(3):332-339. 10.3988/jcn.2016.12.3.332.

Procalcitonin as a Diagnostic and Prognostic Factor for Tuberculosis Meningitis

• Kim J
• Kim SE
• Park BS
• Shin KJ
• Ha SY
• Park J
• Kim SE
• Park KM

• KMID: 2354121
• DOI: http://doi.org/10.3988/jcn.2016.12.3.332

Abstract

BACKGROUND AND PURPOSE
We investigated the potential role of serum procalcitonin in differentiating tuberculosis meningitis from bacterial and viral meningitis, and in predicting the prognosis of tuberculosis meningitis.
METHODS
This was a retrospective study of 26 patients with tuberculosis meningitis. In addition, 70 patients with bacterial meningitis and 49 patients with viral meningitis were included as the disease control groups for comparison. The serum procalcitonin level was measured in all patients at admission. Differences in demographic and laboratory data, including the procalcitonin level, were analyzed among the three groups. In addition, we analyzed the predictive factors for a prognosis of tuberculosis meningitis using the Glasgow Coma Scale (GCS) at discharge, and the correlation between the level of procalcitonin and the GCS score at discharge.
RESULTS
Multiple logistic regression analysis showed that a low level of procalcitonin (≤1.27 ng/mL) independently distinguished tuberculosis meningitis from bacterial meningitis. The sensitivity and specificity for distinguishing tuberculosis meningitis from bacterial meningitis were 96.2% and 62.9%, respectively. However, the level of procalcitonin in patients with tuberculosis meningitis did not differ significantly from that in patients with viral meningitis. In patients with tuberculosis meningitis, a high level of procalcitonin (>0.4 ng/mL) was a predictor of a poor prognosis, and the level of procalcitonin was negatively correlated with the GCS score at discharge (r=-0.437, p=0.026).
CONCLUSIONS
We found that serum procalcitonin is a useful marker for differentiating tuberculosis meningitis from bacterial meningitis and is also valuable for predicting the prognosis of tuberculosis meningitis.

Keyword

tuberculosis; bacteria; procalcitonin; prognosis

MeSH Terms

Bacteria
Glasgow Coma Scale
Humans
Logistic Models
Meningitis, Bacterial
Meningitis, Viral
Prognosis
Retrospective Studies
Sensitivity and Specificity
Tuberculosis*
Tuberculosis, Meningeal*

Figure

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  Fig. 1 Selection process for patients with tuberculosis, bacterial, and viral meningitis. ICD: The International Classification of Disease.

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  Fig. 2 Results of the correlation analysis. A negative correlation between the serum procalcitonin level and Glasgow Coma Scale score at discharge is identified in patients with tuberculosis meningitis (A), whereas no significant correlation is identified between these parameters in patients with bacterial (B), or viral (C) meningitis.

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