Meningitis: latex agglutination may help diagnose bacterial meningitis but not rule it out

Clinical bottom line (level 4)

  1. A positive latex agglutination made bacterial meningitis or meningococcal septicaemia more likely.
  2. A negative latex agglutination test made bacterial meningitis less likely but cannot safely rule it out (even with ultrasound enhancement).
Barnes et al: Archives of Diseases of Childhood 1998; 78: 58-60
Expires November 2003

The study

Setting: university hospital, UK

80 patients (aged 8 months to 54 years, ?% male) with a clinical suspicion of bacterial meningitis or meningococcal septicaemia

Independent ?blinded reference standard, applied in all patients from a non-consecutive inappropriate spectrum.
Reference standard:
  • CSF, blood, urine culture or serology
Diagnostic test: latex aggutination
  • using test card
  • using ultrasound enhancement

The evidence


diagnostic test meningitis or meningococcal septicaemia other LR+
(95% CI)		 LR-
(95% CI)
agglutination using test card 16 0 -
(3.0 to infinity) 		0.69
(0.57 to 0.83)
agglutination following ultrasound 33 2 9.4
(2.4 to 36) 		0.38
(0.26 to 0.56)
total 51 29

Comments

  1. This is a preliminary report used on an artificial series of patients.
  2. Patients were not representative. Therefore post-test probabilities cannot be calculated.

Citation

  1. Barnes RA, Jenkins P, Coakley WT: preliminary clinical evaluation of meningococcal disease and bacterial meningitis by ultrasonic enhancement. Archives of Diseases of Childhood 1998; 78: 58-60
Contributor: Chris Ball and Clare Wotton, November 1999
Reviewer: Chris Del Mar

Clinical Question.
Patient suspecetd meninigococcal disease
Intervention or Exposure latex agglutination testing
Outcome diagnosis, meningococcal disease confirmed