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

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

BMC Infect Dis. 2014;14:276

Authors: Guiddir T, Deghmane AE, Giorgini D, Taha MK

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 [PubMed - indexed for MEDLINE]

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