What is the role of blood tests in the diagnosis of aseptic meningitis?

Updated: Jul 17, 2018
  • Author: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

The selection of blood tests is guided by the etiologic clues gleaned from the clinical evaluation. Tests that may be useful include the following:

  • CBC with differential

  • Sedimentation rate, antinuclear antibody, rheumatoid factor

  • Sjögren syndrome antigens A and B

  • Serum protein electrophoresis

  • Lyme titer (enzyme-linked immunosorbent assay [ELISA])

  • VDRL, fluorescent treponemal antibody absorption test (FTA-ABS)

  • Acute and convalescent sera for virus-specific IgG or IgM to enteroviruses, arboviruses, adenoviruses, LCMV, Epstein-Barr virus, and HSV-2

Dubos et al found that measurement of blood procalcitonin (PCT) levels, in combination with other clinical and laboratory parameters, can help distinguish aseptic meningitis from bacterial meningitis. In a study of 198 consecutive children with acute meningitis (aged 29 days to 18 years), a PCT level ≥ 0.5-ng/mL indicated bacterial rather than aseptic meningitis with 99% sensitivity and 83% specificity. [12]


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