Comparison of cerebrospinal fluid parameters with acute phase reactants and hematological parameters in patients presenting to the pediatric emergency department with fever and seizures

In this study, data from 87 pediatric patients aged 1 month to 18 years who presented to the Emergency Pediatric Department of Eskişehir Osmangazi University Faculty of Medicine with complaints of fever and seizures and underwent a lumbar puncture were analyzed retrospectively. The patients were divided into two groups: those diagnosed with meningitis in their cerebrospinal fluid (CSF) and those without meningitis. Of the included patients, 43 (49%) were male, and 44 (51%) were female. Age distribution was as follows: 4 patients (4.5%) were between 1-3 months, 16 (18%) were between 4-12 months, 54 (62%) were between 13-60 months, and 13 (14.5%) were between 61-216 months. Among the 87 patients in the study, 13 (14.9%) had hypoactivity, 16 (18.3%) had decreased feeding, 18 (20.6%) had a tendency to sleep, 19 (21.8%) had altered consciousness, and 15 (17.2%) had vomiting complaints. A causative pathogen was identified in 10 patients (11.4%); 6 (60%) were bacterial, while 4 (40%) were viral pathogens. When evaluating the CSF parameters, the group diagnosed with meningitis had statistically significant findings, including elevated CSF protein levels, decreased CSF glucose levels, the presence of cells in the CSF, and a low CSF glucose/serum glucose ratio. Among the examined parameters, white blood cell count, absolute neutrophil count, neutrophil-to-lymphocyte ratio, mean platelet volume, C-reactive protein, and procalcitonin levels did not show a statistically significant difference between the meningitis and non-meningitis groups. However, lymphopenia was found to be statistically significant in the meningitis group. When the meningitis group was further divided into bacterial and viral meningitis cases, procalcitonin levels were found to be significantly higher in the bacterial meningitis group, with a cut-off value of 3.32 ng/mL (sensitivity: 38.81, specificity: 89.39). This study contributes to the literature by emphasizing the importance of considering risk factors, medical history, physical examination findings, and laboratory results collectively when evaluating patients with febrile seizures in the emergency department who are suspected of having a central nervous system infection. It also highlights the need for performing