The usefulness of serum delta neutrophil index for differentiating bacterial and viral meningitis in the emergency department
Objective When managing patients with acute meningitis in an emergency department (ED), early diagnosis of the type of infection (bacterial or viral) considerably affects the clinical course and treatment because of the high mortality and morbidity associated with bacterial meningitis (BM). The seru...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Korean Society of Emergency Medicine
2016-06-01
|
| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ceemjournal.org/upload/pdf/ceem-15-095.pdf |
| _version_ | 1797897205816754176 |
|---|---|
| author | Joon Woo Lee Chan Ik Park Hyung Il Kim Oh Hyun Kim Kyoung Chul Cha Hyun Kim Kang Hyun Lee Sung Oh Hwang Yong Sung Cha |
| author_facet | Joon Woo Lee Chan Ik Park Hyung Il Kim Oh Hyun Kim Kyoung Chul Cha Hyun Kim Kang Hyun Lee Sung Oh Hwang Yong Sung Cha |
| author_sort | Joon Woo Lee |
| collection | DOAJ |
| description | Objective When managing patients with acute meningitis in an emergency department (ED), early diagnosis of the type of infection (bacterial or viral) considerably affects the clinical course and treatment because of the high mortality and morbidity associated with bacterial meningitis (BM). The serum delta neutrophil index (DNI), a new inflammatory marker, reflects the fraction of circulating immature granulocytes and is elevated in cases of bacterial infection. The objective of this study was to evaluate whether serum DNI can be used to differentiate between BM and viral meningitis (VM) in the ED. Methods This retrospective, observational study included 104 consecutive patients (aged >18 years) diagnosed with acute meningitis from January 2012 to November 2014 in a regional emergency center. White blood cell and neutrophil counts, C-reactive protein level, and DNI were evaluated regarding their usefulness for differentiating BM and VM. Results Serum DNI was not significantly higher in the BM group (n=12) than in the VM group (n=92) (0 [interquartile range, 0% to 2.73%] vs. 0 [interquartile range, 0 to 0%], P=0.057). However, the white blood cell count and C-reactive protein level were statistically higher in the BM group (P=0.034 and P=0.026, respectively). Serum DNI was not found to be a statistically useful differential diagnostic parameter (area under the curve, 0.628; 95% confidence interval, 0.438 to 0.818). Conclusion Currently, there is no evidence that the serum DNI aids in differentiating acute BM from acute VM in the ED. |
| first_indexed | 2024-04-10T07:53:51Z |
| format | Article |
| id | doaj.art-146a8e3564ef4b3bb6a93e53b23163be |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:53:51Z |
| publishDate | 2016-06-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-146a8e3564ef4b3bb6a93e53b23163be2023-02-23T05:45:43ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252016-06-0132959910.15441/ceem.15.09585The usefulness of serum delta neutrophil index for differentiating bacterial and viral meningitis in the emergency departmentJoon Woo Lee0Chan Ik Park1Hyung Il Kim2Oh Hyun Kim3Kyoung Chul Cha4Hyun Kim5Kang Hyun Lee6Sung Oh Hwang7Yong Sung Cha8 Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, KoreaObjective When managing patients with acute meningitis in an emergency department (ED), early diagnosis of the type of infection (bacterial or viral) considerably affects the clinical course and treatment because of the high mortality and morbidity associated with bacterial meningitis (BM). The serum delta neutrophil index (DNI), a new inflammatory marker, reflects the fraction of circulating immature granulocytes and is elevated in cases of bacterial infection. The objective of this study was to evaluate whether serum DNI can be used to differentiate between BM and viral meningitis (VM) in the ED. Methods This retrospective, observational study included 104 consecutive patients (aged >18 years) diagnosed with acute meningitis from January 2012 to November 2014 in a regional emergency center. White blood cell and neutrophil counts, C-reactive protein level, and DNI were evaluated regarding their usefulness for differentiating BM and VM. Results Serum DNI was not significantly higher in the BM group (n=12) than in the VM group (n=92) (0 [interquartile range, 0% to 2.73%] vs. 0 [interquartile range, 0 to 0%], P=0.057). However, the white blood cell count and C-reactive protein level were statistically higher in the BM group (P=0.034 and P=0.026, respectively). Serum DNI was not found to be a statistically useful differential diagnostic parameter (area under the curve, 0.628; 95% confidence interval, 0.438 to 0.818). Conclusion Currently, there is no evidence that the serum DNI aids in differentiating acute BM from acute VM in the ED.http://www.ceemjournal.org/upload/pdf/ceem-15-095.pdfbiochemical markersmeningitisdelta neutrophil index |
| spellingShingle | Joon Woo Lee Chan Ik Park Hyung Il Kim Oh Hyun Kim Kyoung Chul Cha Hyun Kim Kang Hyun Lee Sung Oh Hwang Yong Sung Cha The usefulness of serum delta neutrophil index for differentiating bacterial and viral meningitis in the emergency department Clinical and Experimental Emergency Medicine biochemical markers meningitis delta neutrophil index |
| title | The usefulness of serum delta neutrophil index for differentiating bacterial and viral meningitis in the emergency department |
| title_full | The usefulness of serum delta neutrophil index for differentiating bacterial and viral meningitis in the emergency department |
| title_fullStr | The usefulness of serum delta neutrophil index for differentiating bacterial and viral meningitis in the emergency department |
| title_full_unstemmed | The usefulness of serum delta neutrophil index for differentiating bacterial and viral meningitis in the emergency department |
| title_short | The usefulness of serum delta neutrophil index for differentiating bacterial and viral meningitis in the emergency department |
| title_sort | usefulness of serum delta neutrophil index for differentiating bacterial and viral meningitis in the emergency department |
| topic | biochemical markers meningitis delta neutrophil index |
| url | http://www.ceemjournal.org/upload/pdf/ceem-15-095.pdf |
| work_keys_str_mv | AT joonwoolee theusefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT chanikpark theusefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT hyungilkim theusefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT ohhyunkim theusefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT kyoungchulcha theusefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT hyunkim theusefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT kanghyunlee theusefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT sungohhwang theusefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT yongsungcha theusefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT joonwoolee usefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT chanikpark usefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT hyungilkim usefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT ohhyunkim usefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT kyoungchulcha usefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT hyunkim usefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT kanghyunlee usefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT sungohhwang usefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment AT yongsungcha usefulnessofserumdeltaneutrophilindexfordifferentiatingbacterialandviralmeningitisintheemergencydepartment |