Procalcitonin, Midregional Proenkephalin A and N-terminal Protachykinin A in cerebrospinal fluid to differentiate bacterial from viral meningitis

Levels of procalcitonin (PCT) are elevated in many conditions leading to systemic inflammatory response syndrome (SIRS), as following bacterial infection (Assicot et al., 1993), pancreatitis (Rau et al., 1997), burns (Nylen et al., 1992) or polytrauma (Mimoz et al., 1998). However, the presence of PCT in cerebrospinal fluid is less well examined. A few studies focused on meningitis, where PCT in CSF was undetectable (Gendrel et al., 1997), elevated (Jereb et al., 2001; Kepa et al., 2005) or not different from control levels (Shimetani et al., 2001). In addition, a significant increase of PCT in CSF in patients with acute neuroinflammation (e.g. encephalitis and meningitis) was reported (Ernst et al. 2007).