Original Articles
Clinical presentation and CSF analysis in childhood meningitis and role of CSF LDH in diagnosis | |
Dr. Mothkuri Vigneshwar, Dr. Subhasree Beura, Dr. Ipsita Sahoo, Dr. Debasmita Rath, Dr. Basudev Biswal, Dr. Braja Kishore Behera | |
Introduction: Meningitis is one of the commonest diseases in children. Standard routine analysis of CSF in meningitis does not always provide rapid definitive information as for as causative agent is concerned. Objective of the study: To evaluate the clinical presentation and CSF analysis in childhood meningitis with special reference to LDH estimation. Material & methods: Study was conducted in the department of Pediatrics Institute of Medical sciences & SUM Hospital. Cases of different types of meningitis between 1 month to 14 yrs were taken and 21 cases of febrile convulsion were taken as controls. Cases below 1 month age and traumatic or dry tap were excluded from the study. Results were analyzed by descriptive statistical analysis, Kruskall Wallis test, chi-square/fisher exact test were used. Results: Viral meningitis was the commonest type of meningitis in this study comprising 38.7%. Male cases were more comprising 66.7%. TBM common in >5 yr age group, pyogenic and viral meningitis were common in 1-5yrs age group. Fever, convulsion, vomiting and headache were the commonest symptoms. Neck rigidity, altered sensorium, cranial nerve palsy and motor weakness were the commonest signs. CSF protein was significantly high in TBM, slightly elevated in pyogenic meningitis. LDH was elevated (>60IU/dl) in 100% cases in pyogenic meningitis and 87.5% in TBM, 24% cases of viral meningitis. Conclusion: To conclude, even though LDH activity is used as supportive evidence of meningeal inflammation, as this test is cost effective can be used on regular basis along with other routine tests to diagnose meningitis and for differentiation of pyogenic, tubercular and viral meningitis. |
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