Accuracy of cerebrospinal leucocyte count, protein and culture for the diagnosis of acute bacterial meningitis: a comparative study using Bayesian latent class analysis.

OBJECTIVE

To examine the utility of laboratory methods other than bacterial culture in diagnosing acute bacterial meningitis (ABM).

METHODS

Bayesian latent class analysis was used to estimate diagnostic precision of cerebrospinal fluid (CSF) culture, leucocyte counts and protein concentrations for ABM in Melanesian children.

RESULTS

With a cut-off of ≥20 leucocytes/mm(3) , the area under the receiver operating characteristic curve (AUC ROC) was >97.5% for leucocyte counts. A lower (93%) AUC ROC was observed for CSF protein concentrations ≥1 g/l. CSF culture had poor sensitivity and high specificity.

CONCLUSION

Leucocyte counts provide sufficient diagnostic precision to aid clinical decision-making in ABM.