Mean platelet volume in the differential diagnosis of tuberculous and bacterial meningitis

  • Carlos Rodrigo Camara-Lemarroy University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
  • Guillermo Delgado-Garcia University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
  • Juan Gilberto De la Cruz-Gonzalez University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
  • Hector Jorge Villareal-Velazquez University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
  • Fernando Gongora-Rivera University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
Keywords: meningitis, mean platelet volume, inflammation, platelets, thrombocytopenia

Abstract

Introduction: Mean platelet volume (MPV) has been shown to reflect the inflammatory burden in different inflammatory and autoimmune diseases. Our objective was to analyze the MPV in patients with tuberculous (TBM) and bacterial meningitis (BM).

Methodology: The demographic and clinical data of 73 consecutive patients that presented with either BM (n = 35) or TBM (n = 38) were retrospectively analyzed, as well as that of 28 age- and sex-matched controls.

Results: MPV was 8.78 ± 1.58 fL in patients with BM and 6.42 ± 1.39 fL in the TBM group (p < 0.05). In the control group, MPV was 7.4 ± 0.66 fL, significantly higher and lower when compared with TBM and BM, respectively. MPV was significantly associated with diagnosis (adjusted OR: 5.15, 95% CI: 1.090–23.7; p = 0.03). With the optimal cut-off value of 7.62 fL, MPV had 82% sensibility and 78% specificity for the differential diagnosis of TBM versus BM. Lower platelet counts, higher serum creatinine, higher white blood cell counts, and higher blood-cerebrospinal fluid glucose ratio were also predictive of BM.

Conclusions: Platelet counts were lower and MPV was higher in patients with BM compared to patients with TBM.  Platelet indices, available in routine bloodwork, could be useful in the early differential diagnosis of these entities.

Author Biographies

Carlos Rodrigo Camara-Lemarroy, University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
Neurology Service, University Hospital “Dr. Jose E. González”
Guillermo Delgado-Garcia, University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
Department of Internal Medicine, University Hospital “Jose E. Gonzalez”
Juan Gilberto De la Cruz-Gonzalez, University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
Neurology Service, University Hospital “Dr. Jose E. González”
Hector Jorge Villareal-Velazquez, University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
Neurology Service, University Hospital “Dr. Jose E. González”
Fernando Gongora-Rivera, University Hospital “Dr. Jose E. González”, Autonomous University Of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
Neurology Service, University Hospital “Dr. Jose E. González”
Published
2017-02-28
How to Cite
1.
Camara-Lemarroy CR, Delgado-Garcia G, De la Cruz-Gonzalez JG, Villareal-Velazquez HJ, Gongora-Rivera F (2017) Mean platelet volume in the differential diagnosis of tuberculous and bacterial meningitis. J Infect Dev Ctries 11:166-172. doi: 10.3855/jidc.7478
Section
Original Articles