Title: 531 PREDICTIVE VALUE OF C-REACTIVE PROTEIN (C-RP) AND LIMULUS LYSATE ASSAY (LLA) IN EVALUATION OF CHILDHOOD BACTERIAL MENINGITIS
Abstract: Bacterial meningitis is often difficult to distinguish from viral meningitis at the time a patient is first examined. LLA for detection of gram neg. bacterial endotoxin and C-RP have been proposed as useful adjuncts for the rapid detection of bacterial meningitis. However, reports conflict as to the value of these tests. We evaluated both assays during a prospective study of meningitis from 11/82 to 9/84. 246 patients underwent lumbar puncture for suspected meningitis. The table summarizes the results from patients whose specimens grew pathogenic bacteria. Also included were all patients with 10 WBC/mm3 of CSF with negative bacterial cultures and no prior antibiotics. Predictive value of LLA was 100% and should be studied further. Predictive value of a negative C-RP test was 88%, but all patients with + bacterial CSF cultures were accurately predicted by a combination of test results (C-RP, protein, glucose, WBC, gram stain).