VALUE OF RAPID ANTIGEN ASSAY IN DIAGNOSIS OF PYOGENIC AND PARTIALLY TREATED MENINGITIS

Objective: To assess the usefulness of rapid antigen assay in diagnosis of pyogenic meningitis and to compare CSF culture with Rapid antigen Assay in pyogenic meningitis in terms of percentage recovery of the pathogen. Research Design and Methods: The prospective observational study was conducted on all suspected cases of meningitis, admitted in Bal Chikitsalaya, Department of Paediatrics, RNT Medical College, Udaipur over a period of 6 months. A total of 20 children with pyogenic meningitis were enrolled in our study. Their haematological and CSF cytochemical findings, management, clinical course during illness and outcome were also recorded and analyzed. Rapid Antigen detection by Latex Agglutination Test was compared with CSF culture. Results: In our study, the overall positivity on Rapid Antigen assay was 85% of cases with a sensitivity and specificity of 85% and 100% respectively. This in sharp contrast to CSF gram’s stain and culture where the results were positive in 55% and 40% cases respectively.Streptococcus pneumoniae was the commonest organism isolated on Rapid antigen assay in 47.06% followed by Neisseria meningtidis in 35.29% and Hemophilus Influenzae in 11.76% .Case fatality rate was 15% in our study. Conclusions: We concluded that Rapid antigen asssay has high sensitivity and specificity .So, it can be advised as an additional laboratory investigation to found etiology of bacterial meningitis mainly in pretreated cases and also differentiate partially treated cases from that of tubercular meningitis as it is a common dilemma encountered by the clinicians.