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Open Access Research article

Lipocalin 2 in cerebrospinal fluid as a marker of acute bacterial meningitis

Tamazoust Guiddir, Ala-Eddine Deghmane, Dario Giorgini and Muhamed-Kheir Taha*

Author Affiliations

Institut Pasteur, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci, 28 Rue du Dr Roux, 75724 Paris, Cedex 15, France

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BMC Infectious Diseases 2014, 14:276  doi:10.1186/1471-2334-14-276

Published: 20 May 2014

Abstract

Background

Early differential diagnosis between acute bacterial and viral meningitis is problematic. We aimed to investigate whether the detection of lipocalin 2, a protein of the acute innate immunity response, may be used as a marker for acute bacterial meningitis.

Methods

Transgenic mice expressing the human transferrin were infected by intraperitoneal route and were imaged. Cerebrospinal fluid (CSF) was sampled up to 48hours post- infection to measure lipocalin 2. We also tested a collection of 90 and 44 human CSF with confirmed acute bacterial or acute viral meningitis respectively.

Results

Lipocalin 2 was detected after 5 h in CSF during experimental infection in mice. Lipocalin 2 levels were significantly higher (p < 0.0001) in patients with confirmed acute bacterial meningitis (mean 125 pg/mL, range 106–145 pg/mL) than in patients with acute viral meningitis (mean 2 pg/mL, range 0–6 pg/mL) with a sensitivity of 81%, a specificity of 93%, a positive predictive value of 96% and a negative predictive value of 71% in diagnosing acute bacterial meningitis.

Conclusions

Increased levels of lipocalin 2 in cerebrospinal fluid may discriminate between acute bacterial and viral meningitis in patients with clinical syndrome of meningitis.

Keywords:
Meningitis; Lipocalin 2; Inflammation; Cerebrospinal fluid; Diagnosis