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Accuracy of cerebrospinal fluid ferritin for purulent meningitis
  1. Pedro Celiny Ramos Garcia1,
  2. Andrea Lucia Machado Barcelos2,
  3. Cristian Tedesco Tonial1,
  4. Humberto Holmer Fiori1,
  5. Paulo Roberto Einloft1,
  6. Caroline Abud Drumond Costa1,
  7. Janete L Portela2,
  8. Francisco Bruno1,
  9. Ricardo Garcia Branco3
  1. 1 Postgraduate Program in Pediatrics and Child Health, Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil
  2. 2 Universidade Federal de Santa Maria, Santa Maria, Brazil
  3. 3 Pediatric Intensive Care Unit, Sidra Medical and Research Center, Doha, Qatar
  1. Correspondence to Dr Cristian Tedesco Tonial, PUCRS, Porto Alegre 90820090, Brazil; cristiantonial{at}


Objective To evaluate the use of cerebrospinal fluid (CSF) ferritin levels in the diagnosis of purulent meningitis (PM).

Method We studied 81 children between 28 days and 12 years of age who presented with clinical suspicion of meningitis to the emergency department. CSF ferritin levels were measured and compared between diagnostic groups (PM, aseptic meningitis (AM) and no meningitis).

Results The median age was 24 (IQR 8–69) months. There were 32 patients with AM (39%), 23 with PM (28%) and 26 with no meningitis (32%). Median CSF ferritin was 4.2 ng/mL (IQR 3.0–6.5), 52.9 ng/mL (IQR 30.7–103 ng/mL) and 2.4 ng/mL (IQR 2–4), respectively. CSF ferritin was higher in children with PM compared with AM (p<0.001) or no meningitis (p<0.001). There was no difference between AM and no meningitis.

Conclusion CSF ferritin may be a useful biomarker to discriminate PM in children with clinical symptoms of this disease.

  • ferritin
  • meningitis
  • cerebrospinal fluid
  • biomarker

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  • Contributors PCRG, ALMB, CTT and RB conceptualised and designed the study, and the data collection instruments, collected data, carried out the initial analyses, drafted the initial manuscript, and reviewed and revised the manuscript. HHF, CADC, JLP, PRE and FB conceptualised and designed the study, coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The protocol was approved by the ethics committee of the main institution under registry number CAAE-17300913.6.1001.5336.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Deidentified data may be available from the corresponding author upon reasonable request and approval from participating institutions and local ethics committee.

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