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Emergency-Accident
ROLE OF C-REACTIVE PROTEIN (CRP) IN THE DIFFERENTIATION OF LYME AND VIRAL MENINGITIS IN A LYME-ENDEMIC AREA
  1. A D DePiero1,2,
  2. M W Attia1,2
  1. 1AI Dupont Hospital for Children, Wilmington, Delaware, USA
  2. 2Department of Pediatrics, Jefferson Medical College, Philadelphia, Pennsylvania, USA

Abstract

Objective To determine the ability of C-reactive protein (CRP) to differentiate viral and Lyme meningitis in children.

Methods Children ages 2–18 years were prospectively enrolled over three consecutive seasons. during which Lyme disease was prevalent when the attending physician had concern for meningitis. A CRP was obtained on all patients undergoing lumbar puncture. The study received approval from the Institutional Review Board. Statistical analysis was performed using SPSS 11.5 for Windows (SPSS Inc, Chicago, IL).

Results Over the three study periods, 80 patients were enrolled. The results are shown in the table.

View this table:

DePiero et al CRP concentrations in patients with suspected meningitis

Conclusions CRP appears to be unhelpful in differentiating Lyme and viral meningitis. Despite published data that suggest CRP is elevated in most patients with Lyme disease (4), we did not find the CRP to be consistently elevated in patients with Lyme meningitis.

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