Correlation between leukocyte aggregation score of cerebrospinal fluid and bacterial meningitis in children

Main Article Content

Meitha PE Togas
Nurhayati Masloman

Abstract

Background Bacterial meningitis is one of life-threatening dis-
eases and carries a risk of sequelae in affected children. In terms
of cost and rapid differentiation between bacterial and non-bacte-
rial meningitis, several tests have been proposed.
Objective This study aimed to determine the use of leukocyte
aggregation score (LAS) of cerebrospinal fluid (CSF) in diagnos-
ing bacterial meningitis.
Methods A prospective analytic study was done from October 2001
to July 2002 in the Department of Child Health, Medical School,
Sam Ratulangi University/ Manado General Hospital. Children pre-
senting with symptoms of meningitis, aged between 28 days and
13 years were enrolled. LAS was counted in percentage. Regres-
sion analysis was used to determine the correlation between LAS
and diagnosis of bacterial meningitis.
Results CSF examinations were done on 35 meningitis patients.
Three patients were excluded. The remaining 32 patients com-
prised of 11 with bacterial meningitis and the other 21 with non-
bacterial meningitis. The mean of LAS in bacterial meningitis was
significantly higher than that of non-bacterial meningitis (p<0.001).
The cut off value of LAS to diagnose bacterial meningitis was
12.35%.
Conclusion LAS may be used as a fast and simple alternative
diagnostic tool to confirm the diagnosis of bacterial meningitis

Article Details

How to Cite
1.
Togas M, Masloman N. Correlation between leukocyte aggregation score of cerebrospinal fluid and bacterial meningitis in children. PI [Internet]. 10Oct.2016 [cited 19Jul.2019];44(2):61-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/738
Section
Articles
Author Biographies

Meitha PE Togas

Department of Child Health, Medical School,
Sam Ratulangi University, Manado General Hospital, Manado.

Nurhayati Masloman

Department of Child Health, Medical School,
Sam Ratulangi University, Manado General Hospital, Manado.
Received 2016-09-29
Accepted 2016-09-29
Published 2016-10-10

References

1. Klein JO, Feigin RD, Mc Cracken GH. Report of the
task force on diagnosis and management of meningi-
tis. Pediatrics 1986;78:959-79.
2. Snyder RD. Bacterial and spirochaetal infections of the
nervous system. In: Swaiman KF, editor. Pediatric neu-
rology: principles and practice. Toronto: Mosby Co;
1994. p. 611-43.
3. Berkley JA, Mwangi I, Ngetsa J, Mwarumba S, Lowe
BS, Marsh K, et al. Diagnosis of acute bacterial menin-
gitis in children at a district hospital in Saharan Afri-
can. Lancet 2001;357:1753-7.
4. Rutledge J, Benjamin D, Hood L, Smith A. Is the cere-
brospinal fluid lactate measurement useful in the man-
agement of children with suspected bacterial meningi-
tis? J Pediatr 1981;98:20-4.
5. Coral CJ, Pepple JM, Moxon ER, Hughes WT. C-reac-
tive protein in spinal fluid of children with meningitis.
J Pediatr 1981;99:365-9.
6. De Beer FC, Kirsten GF, Gie RP, Beyers N, Strachan
AF. Value of C-reactive protein measurement in tu-
berculous, bacterial and viral meningitis. Arch Dis
Child 1984;59:653-6.
7. Gutteberg TJ, Flaegstad T, Jorgensen T. Lactoferrin,
C-reactive protein, á-1 antitrypsin and immunoglobu-
lin GA in cerebrospinal fluid in meningitis. Acta Pediatr
Scand 1986;75:569-72.
8. Nadal D, Leppert D, Frei K, Lamche H, Fontana A.
Tumor necrosis factor-á in infectious meningitis. Arch
Dis Child 1989;64:1274-9.
9. Mustafa MM, Ramilo O, Llorens XS, Olsen KD,
Magness RR, Mc Cracken GH. Cerebrospinal fluid
prostaglandins, interleukin 1-â and tumor necrosis fac-
tor in bacterial meningitis. Clinical and laboratory cor-
relations in placebo treated and dexamethasone treated
patients. Am J Dis Child 1990;144:883-7.
10. Lopez-Cortez LF, Cruz-Ruiz M, Gomez-Mateos J,
Jimenez-Hernandez D, Palomino J, Jimenez E.
Measurement of levels of tumor necrosis factor-α
and interleukin 1-α in the cerebrospinal fluid of
the patients with meningitis of different etiolo-
gies: utility in the differential diagnosis. Clin Inf
Dis 1993;16:534-9.
11. Ramilo O, Mustafa MM, Porter J, Saez-Lorens X,
Mertsola J, Olsen KD, et al. Detection of interleukin
1-α but not tumor necrosis factor-α in cerebrospinal
fluid of children with aseptic meningitis. Am J Dis
Child 1990;144:349-52.
12. Dulkerian SJ, Kilpatrick L, Costarino Jr AT, Mc Cawley
L, Fein J, Corcoran J, et al. Cytokine elevations in in-
fants with bacterial and aseptic meningitis. J Pediatr
1995;126:872-6.
13. Shimoda BK, Okamura S, Omori F, Mizuno Y, Hara T,
Aoki T, et al. Granulocyte colony-stimulating factor in
cerebrospinal fluid from patients with meningitis. Blood
1991;77:2214-7.
14. Bhisitkul DM, Hogan AE, Tanz RR. The role of bac-
terial antigen detection tests in the diagnosis of bacte-
rial meningitis. Pediatr Emerg Care 1994;10:67-71.
15. Garty B, Berliner S, Liberman E, Danon YL. Cere-
brospinal fluid leucocyte aggregation in meningitis.
Pediatr Inf Dis J 1997;16:647-51.
16. Michelow IC, Nicol M, Tiemessen C, Chezzi C, Pettifor
JM. Value of cerebrospinal fluid leucocyte aggregation
in distinguishing the causes of meningitis in children.
Pediatr Inf Dis J 2000;19:66-72.
17. Vince J, Biddulph J. Infections of the nervous system.
In: Jeliffe DB, editor. Child health in the tropics. A prac-
tical handbook for health personnel. 5 th ed. USA: ELBS;
1985. p. 148-55.
18. Hashimoto T. Gram stain technique [citated on Au-
gust 13, 2002]. University Health System. 1995-
2000. Available from URL: http://www.meddean.
luc.edu/lumen/Deptwebs/microbio/med/gram/
tech.htm.
19. Wenger JD, Hihgtower AW, Facklam RR, Gaventa S,
Broome CV. Bacterial meningitis in the United States
1986: report of a multistate surveillance study. J Inf Dis
1990;162:1313-23.
20. Weil ML. Infections of the nervous system. In: Menkes
JH, editor. Textbook of child neurology. 4 th ed. London:
Lea and Febiger; 1990. p. 327-45.
21. Hutchison JH, Cockburn F. Practical pediatric problems.
6 th ed. London: Llyod-Luke; 1986. p. 526-34.
22. Haerer AF. De Jong’s neurologic examination. 5 th ed.
Philadelphia: JB Lippincott Co; 1992. p. 777-88.
23. Polk DB, Steele RW. Bacterial meningitis presenting
with normal cerebrospinal fluid. Pediatr Inf Dis J
1987;6:1040-2.
24. Menkes JH. The causes of low spinal fluid sugar in
bacterial meningitis: another look. Pediatrics
1969;44:1-3.