Pentraxin 3: a novel biomarker in pediatric central nervous system infections.

Background: Pediatric CNS infections have been identified as a global health problem, associated with an increased death rate and fatal consequences. Pentraxin 3 (PTX3) is an acute-phase mediator that increases in body fluids and plasma throughout inflammation. Our study was designed to assess the diagnostic and prognostic value of cerebrospinal fluid (CSF) PTX3 levels in pediatric patients with different central nervous system (CNS) infections.

Methods: We enrolled 100 children hospitalized at Fayoum University Children's Hospital with suspected CNS infections fulfilling the case criteria for CNS infections. We recorded their medical history and examination data upon admission. The C-reactive protein (CRP) level, complete blood count (CBC), CSF PTX3 level, CSF analysis and culture, and blood culture were assessed in all patients at the time of admission.

Results: Levels of PTX3 were significantly correlated with the duration of symptoms before admission, length of hospital stay, patient outcomes, CRP levels, CSF findings, and CSF cultures (P value < 0.001). Patients who needed mechanical ventilation or experienced adverse outcomes had greater levels of PTX3, which were more prevalent in those with a bacterial etiology (P value < 0.05).

Conclusion: PTX3 indicates disease severity and prognosis. PTX3 showed statistically significant sensitivity when discriminating between bacterial and aseptic CNS infections, as well as between bacterial CNS infections and controls. However, it has lower sensitivity and specificity than other CSF biomarkers, though it is higher than serum CRP.