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BMC Infect Dis. 2014 May 20;14:276. doi: 10.1186/1471-2334-14-276.

Lipocalin 2 in cerebrospinal fluid as a marker of acute bacterial meningitis.

Author information

1
Institut Pasteur, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci, 28 Rue du Dr Roux, 75724 Paris, Cedex 15, France. mktaha@pasteur.fr.

Abstract

BACKGROUND:

Early differential diagnosis between acute bacterial and viral meningitis is problematic. We aimed to investigate whether the detection of lipocalin 2, a protein of the acute innate immunity response, may be used as a marker for acute bacterial meningitis.

METHODS:

Transgenic mice expressing the human transferrin were infected by intraperitoneal route and were imaged. Cerebrospinal fluid (CSF) was sampled up to 48hours post- infection to measure lipocalin 2. We also tested a collection of 90 and 44 human CSF with confirmed acute bacterial or acute viral meningitis respectively.

RESULTS:

Lipocalin 2 was detected after 5 h in CSF during experimental infection in mice. Lipocalin 2 levels were significantly higher (p < 0.0001) in patients with confirmed acute bacterial meningitis (mean 125 pg/mL, range 106-145 pg/mL) than in patients with acute viral meningitis (mean 2 pg/mL, range 0-6 pg/mL) with a sensitivity of 81%, a specificity of 93%, a positive predictive value of 96% and a negative predictive value of 71% in diagnosing acute bacterial meningitis.

CONCLUSIONS:

Increased levels of lipocalin 2 in cerebrospinal fluid may discriminate between acute bacterial and viral meningitis in patients with clinical syndrome of meningitis.

PMID:
24885531
PMCID:
PMC4033677
DOI:
10.1186/1471-2334-14-276
[Indexed for MEDLINE]
Free PMC Article

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