Utility of latex agglutination test in the diagnosis of acute pyogenic meningitis

Introduction: Acute pyogenic meningitis is one of the most common and devastating Central Nervous System. Difficulty and delay in diagnosis adds to problem in early management of patients. Rapid tests need to be invented so as to curbing the acute pyogenic meningitis cases. Aims: To identify the bacterial pathogens causing acute pyogenic meningitis and to evaluate the role of microscopy, Latex agglutination vis a vis culture in the diagnosis of pyogenic meningitis Methods: Clinically diagnosed cases of Acute pyogenic meningitis were included in the study. Cerebrospinal fluid (CSF) was the specimen of choice. CSF was processed in the microbiology laboratory for bacteriological aerobic culture, microscopy and Latex Agglutionation test (LAT). All the results analyzed statistically. Results: A total of 321 CSF specimens were screened. Among these 50 were from exclusive acute cases . On analysis gram stain positivity was 52%. Sensitivity of the gram staining was 64.29% and specificity was 52.78% while Culture positivity was 28%. Though LAT positivity (27.28%) was less as compared to microscopy and culture, LAT was found to be having higher sensitivity of 71.43% and specificity 80.55% . Conclusion: LAT can be an valuable tool in early diagnosis of acute pyogenic meningitis cases even after administration of antibiotics. It can be used as an adjunctive to culture and microscopy. In country like India, use of LAT should be concentrated on highly suspicious cases to make it cost-effective.