Comparison of the Demographic and Laboratory Profiles of Patients with Aseptic Meningitis and Encephalitis: Significance of Age and C-reactive Protein

Kang Min Park; Kyong Jin Shin; Sam Yeol Ha; Jin Se Park; Bong Soo Park; Sung Eun Kim

doi:10.14253/kjcn.2014.16.2.55

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Park, Shin, Ha, Park, Park, and Kim: Comparison of the Demographic and Laboratory Profiles of Patients with Aseptic Meningitis and Encephalitis: Significance of Age and C-reactive Protein

Original Article

Korean J Community Nutr 2014;16(2):55-61.

Published online: 18 January 2014

DOI: https://doi.org/10.14253/kjcn.2014.16.2.55

Comparison of the Demographic and Laboratory Profiles of Patients with Aseptic Meningitis and Encephalitis: Significance of Age and C-reactive Protein

Kang Min Park^1*, Kyong Jin Shin^1*, Sam Yeol Ha¹, Jin Se Park¹, Bong Soo Park², Sung Eun Kim¹

¹Departments of Neurology and Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea

²Departments of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea

Address for correspondence; Sung Eun Kim Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, 875 Haeundae-ro, Haeundae-gu, Busan 612-896, Korea Tel: +82-51-797-1190 Fax: +82-51-797-1191 E-mail: epidoc@inje.ac.kr

Received 23 December 2013 Revised 12 August 2014 Accepted 1 October 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

Viruses can cause either meningitis or encephalitis. It is unclear why some people suffer from aseptic meningitis, and others acquire aseptic encephalitis when infected with the same viral pathogens. The aim of this study was to compare demographic and laboratory factors between patients with aseptic meningitis and encephalitis.

Methods:

The demographic and laboratory differences were analyzed according to age, sex, diabetes, hypertension, C-reactive protein in the blood, white blood cell and protein in the cerebrospinal fluid, and glucose ratio (cerebrospinal fluid/blood). Additionally, we analyzed the nation-wide differencesin age between the patients with aseptic meningitis and those with encephalitis in Korea.

Results:

The patients with aseptic encephalitis were older, more likely to have hypertension, and had higher levels of C-reactive protein than did the patients with aseptic meningitis. However, the numbers of white blood cells in the cerebrospinal fluid were significantly higher in the patients with meningitis than in the patients with encephalitis. Multivariable analysis revealed that age >49 years, hypertension and a C-reactive protein level >5.81 mg/dL were independent and significant variables in the prediction of aseptic encephalitis. Additionally, the patients with aseptic encephalitis were older than those with aseptic meningitis in the nation-wide Korean database.

Conclusions:

Older age, hypertension, and higher levels of C-reactive protein are useful factors for the prediction of aseptic encephalitis. (Korean J Clin Neurophysiol 2014;16:55-61)

Keywords: Blood-brain barrier, Meningitis, Encephalitis, Age, C-reactive protein

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Table 1.

Comparisons of the demographic and laboratory profiles of the patients with aseptic meningitis and encephalitis

Parameter	Meningitis (n=89)	Encephalitis (n=18)	p-value
Men, n (%)	52 (58.4)	13 (72.2)	0.3049
Mean age, years (±SD)	32 (±12)	56 (±13)	<0.0001
Hypertension, n (%)	2 (2)	9 (50)	<0.0001
Diabetes, n (%)	1 (1)	1 (5)	0.3094
Median WBC^*, mm³ (95% CI)	130 (84-217)	36 (18-91)	0.0326
Median protein^*, mg/dL (95% CI)	51 (44-62)	66 (44-96)	0.1882
Mean glucose ratio^† (±SD)	0.56 (±0.089)	0.57 (±0.114)	0.6555
Median CRP^‡, mg/dL (95% CI)	0.43 (±3.17)	1.28 (8.00)	0.0474

^* Cerebrospinal fluid;

^† Cerebrospinal fluid/blood;

^‡ Blood. WBC; white blood cell, CRP; C-reactive protein, CI; confidence interval.

Table 2.

Results of multivariate analysis of the variables of the patients with aseptic meningitis and encephalitis

Independent variable	Adjusted odds ratio	95% confidence interval	p-value
Age (>49 years)	27	4.6-163.9	0.0003
Hypertension	15	1.7-132.5	0.0153
WBC^* (<95/mm³)	4	0.5-23.7	0.1925
CRP^† (>5.81 mg/dL)	15	1.1-92.1	0.0201

^* Cerebrospinal fluid; ^†Blood.

WBC; white blood cell, CRP; C-reactive protein.

Table 3.

Sensitivities, specificities, positive predictive values, and negative predictive values in the prediction of aseptic encephalitis by variable

Independent variable	Sensitivity	Specificity	Positive predictive value	Negative predictive value
Age (>49 years)	0.78	0.91	0.64	0.95
Hypertension	0.50	0.98	0.82	0.91
CRP^* (>5.81 mg/dL)	0.30	0.91	0.43	0.87

^* Blood.

CRP; C-reactive protein.

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