Differential Diagnosis of Bacterial and Viral Meningitis Using Dominance-Based Rough Set Approach

2019 ◽  
pp. 29-38
Author(s):  
Ewelina Gowin ◽  
Jerzy Błaszczyński ◽  
Roman Słowiński ◽  
Jacek Wysocki ◽  
Danuta Januszkiewicz-Lewandowska
Keyword(s):  
Differential Diagnosis ◽  
Rough Set ◽  
Viral Meningitis

scholarly journals Comparison of Cerebrospinal Fluid Biomarkers for Differential Diagnosis of Acute Bacterial and Viral Meningitis with Atypical Cerebrospinal Fluid Characteristics

2019 ◽  
Vol 29 (3) ◽  
pp. 244-254 ◽  
Author(s):  
Sérgio Monteiro de Almeida ◽  
Suélen Maria Parizotto Furlan ◽  
Arianne Maris Munhoz Cretella ◽  
Bruna Lapinski ◽  
Keite Nogueira ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Positive Likelihood Ratio ◽  
Viral Meningitis ◽  
Acute Bacterial Meningitis ◽  
Blood Levels ◽  
Csf Biomarkers ◽  
Control Groups ◽  
Easy Method ◽  
Csf Lactate

Objective: Several cerebrospinal fluid (CSF) biomarkers are used to distinguish between acute bacterial meningitis (BM) and viral meningitis (VM). We compared the ability of lactate and glucose (GL) in CSF and the CSF/blood GL ratio to distinguish between acute BM and VM with typical and atypical CSF characteristics. Methods: Three hundred and twenty-four CSF reports were included, which were distributed as the acute BM, VM, and normal control groups (n = 63, 139, and 122, respectively). Results: Lactate level in the CSF of acute BM group was 4-fold higher than that in the acute VM and control groups (p < 0.0001). CSF lactate presented higher specificity (92%) and negative predictive value (94%) compared to CSF GL and CSF/blood GL ratio in distinguishing acute BM and VM. Definitive acute BM or VM with atypical CSF cell characteristics was observed in 23.2 and 21.6% of samples, respectively, and these groups showed reduced performance of characteristics of all CSF biomarkers. CSF lactate showed better operational characteristics than those of CSF GL and CSF/blood GL ratio, presenting the highest positive likelihood ratio, and thus aided in the differential diagnosis of VM with atypical CSF. Conclusion: The CSF lactate assay can be routinely used in laboratories as a rapid, automated, and easy method that is independent of lactate blood levels.

scholarly journals Artificial Intelligence in Differential Diagnostics of Meningitis: A Nationwide Study

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 602
Author(s):  
Alexios-Fotios A. Mentis ◽  
Irene Garcia ◽  
Juan Jiménez ◽  
Maria Paparoupa ◽  
Athanasia Xirogianni ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Age Groups ◽  
Viral Meningitis ◽  
Differential Diagnostics ◽  
Reactive Protein ◽  
Conventional Culture ◽  
Type Plasminogen Activator ◽  
Urokinase Type Plasminogen Activator ◽  
Validation Procedure ◽  
Plasminogen Activator Receptor

Differential diagnosis between bacterial and viral meningitis is crucial. In our study, to differentiate bacterial vs. viral meningitis, three machine learning (ML) algorithms (multiple logistic regression (MLR), random forest (RF), and naïve-Bayes (NB)) were applied for the two age groups (0–14 and >14 years) of patients with meningitis by both conventional (culture) and molecular (PCR) methods. Cerebrospinal fluid (CSF) neutrophils, CSF lymphocytes, neutrophil-to-lymphocyte ratio (NLR), blood albumin, blood C-reactive protein (CRP), glucose, blood soluble urokinase-type plasminogen activator receptor (suPAR), and CSF lymphocytes-to-blood CRP ratio (LCR) were used as predictors for the ML algorithms. The performance of the ML algorithms was evaluated through a cross-validation procedure, and optimal predictions of the type of meningitis were above 95% for viral and 78% for bacterial meningitis. Overall, MLR and RF yielded the best performance when using CSF neutrophils, CSF lymphocytes, NLR, albumin, glucose, gender, and CRP. Also, our results reconfirm the high diagnostic accuracy of NLR in the differential diagnosis between bacterial and viral meningitis.

The association between serum sodium levels and tuberculous meningitis compared to viral and bacterial meningitis: Multicenter retrospective cohort study

2021 ◽  
Author(s):  
Seunghee Na ◽  
Taewon Kim ◽  
In-Uk Song ◽  
Sung-Woo Chung ◽  
Seong-Hoon Kim ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Bacterial Meningitis ◽  
Tuberculous Meningitis ◽  
Serum Sodium ◽  
Retrospective Cohort ◽  
Total Population ◽  
Viral Meningitis ◽  
Lower Serum ◽  
Cross Sectional ◽  
Additional Information

Abstract We evaluated the association between hyponatremia and tuberculous meningitis (TBM) in hopes of providing additional information for the differential diagnosis of TBM from other types of infectious meningitis, especially from viral meningitis (VM). Cross-sectional and longitudinal data involving 5,026 participants more than 18 years of age were analyzed in the total population and the propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, VM, and bacterial meningitis (BM) patients were compared. The initial serum sodium levels were significantly lower in the TBM patients than in the VM and BM patients (136.9 ± 5.9 vs. 139.0 ± 3.1, p < 0.001 for TBM vs. VM, and 138.3 ± 4.7 mmol/L and p < 0.001 for TBM vs. BM) and it dropped significantly more steeply to lower levels in both the TBM and BM patients compared to the VM patients. Consequently, the lowest serum sodium levels were in the order of the TBM < BM < VM patients, which were also statistically significant in all subgroups. (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). The participants with lower serum sodium levels were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium levels than the initial sodium levels (OR 8.4 (95% CI: 4.5–15.8, p < 0.001)). The baseline and longitudinal evaluation of serum sodium levels can provide supportive information for the differential diagnosis of TBM from VM or BM.

scholarly journals Keeping an open mind about meningitis: a case report of carcinomatous meningitis

CJEM ◽  
2011 ◽  
Vol 13 (05) ◽  
pp. 352-356 ◽  
Author(s):  
Andrew Walkty ◽  
Burton Abbott ◽  
Neil Swirsky ◽  
Janice Safneck ◽  
John M. Embil
Keyword(s):  
Differential Diagnosis ◽  
White Cell Count ◽  
Radicular Pain ◽  
Viral Meningitis ◽  
Carcinomatous Meningitis ◽  
Primary Malignancy ◽  
Meningeal Irritation ◽  
Underlying Malignancy ◽  
Elevated Protein ◽  
Leptomeningeal Infiltration

ABSTRACT: Carcinomatous meningitis is defined as leptomeningeal infiltration by malignant cells. A case of carcinomatous meningitis, originally diagnosed as viral meningitis, is presented here to highlight the importance of maintaining a broad differential diagnosis in patients with evidence of meningeal irritation. Clinical and laboratory clues that suggest a diagnosis of carcinomatous meningitis in a patient with meningeal irritation include the presence and type of underlying malignancy (more common with breast cancer, lung cancer, and melanoma), absence of fever, presence of radicular pain, evidence of both cranial and spinal involvement, consistent cerebrospinal fluid (CSF) findings (increased opening pressure, elevated protein concentration, decreased glucose, increased white cell count), and supportive neuroimaging. Diagnosis is based on positive CSF cytology results, which may require multiple lumbar puncture procedures to obtain. For patients with a known primary malignancy who present to the emergency department with symptoms and/or signs of meningeal irritation, carcinomatous meningitis should be included in the differential diagnosis.

scholarly journals Aseptic meningitis as the initial presentation of Leptospira borgpetersenii serovar Tarassovi: two case reports and a literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. G. N. M. K. Bandara ◽  
G. Kalaivarny ◽  
Nilanka Perera ◽  
J. Indrakumar
Keyword(s):  
Differential Diagnosis ◽  
Aseptic Meningitis ◽  
Case Reports ◽  
Viral Meningitis ◽  
Neurological Involvement ◽  
Contaminated Water ◽  
Case Presentation ◽  
Disease Spectrum ◽  
History Of ◽  
Leptospira Borgpetersenii

Abstract Background Leptospirosis is a zoonotic illness caused by pathogenic spirochetes of the genus Leptospira. The disease spectrum ranges from a mild influenza-like presentation to a more serious Weil’s syndrome. Leptospirosis rarely presents as a primary neurological syndrome. We report two cases of Leptospira borgpetersenii serovar Tarasssovi presenting as aseptic meningitis in Sri Lanka. Case presentation We describe case reports of two patients presenting as symptomatic aseptic meningitis due to neuroleptospirosis. Both patients had significant neurological involvement at presentation in the absence of common clinical features of leptospirosis. These patients were initially managed as bacterial or viral meningitis and leptospirosis was suspected due to a history of exposure to contaminated water. Subsequently, they were diagnosed to have neuroleptospirosis by positive Leptospira serology and both patients gained full recovery. Conclusion Our report highlights the importance of considering leptospirosis as a differential diagnosis in patients with aseptic meningitis in endemic settings. Obtaining a detailed occupational and recreational history is helpful in diagnosing neuroleptospirosis promptly. We report the association of Leptospira borgpetersenii serovar (sv.) Tarassovi (strain bakeri) in causing aseptic meningitis, which has not been reported to the best of our knowledge.

Meningitis Due to Mumps Virus in a Child with Acute Leukemia

PEDIATRICS ◽  
1970 ◽  
Vol 46 (6) ◽  
pp. 942-945
Author(s):  
Lothar M.T. Rupprecht ◽  
J. Lawrence Naiman
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Virus Infection ◽  
Acute Leukemia ◽  
Cell Count ◽  
Mononuclear Cell ◽  
Viral Meningitis ◽  
Mumps Virus ◽  
Leukemic Infiltration ◽  
Cerebrospinal Fluid Examination

An 8½-year-old boy with leukemia in remission developed a meningitis-like syndrome associated with increased mononuclear cell count in the cerebrospinal fluid. Examination of the stained CSF sediment showed these to be small lymphocytes rather than lymphoblasts, suggesting a diagnosis of viral meningitis rather than leukemic infiltration of the meninges. Serologic studies gave evidence of a recent mumps virus infection. Viral meningitis should not be overlooked in the differential diagnosis of meningeal reactions in children with leukemia.

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