ABSTRACT
The study included 250 patients admitted to fever hospitals in Egypt with suspected clinical signs and symptoms of bacterial meningitis, their age ranged from six months up to eleven years. Cerebrospinal fluid [CSF] samples isolated from patients were transported to the central health laboratories for confirmation of diagnosis. Physical, cytological, chemical examination for glucose and total protein concentration. Gram stained smear, culture on blood and chocolate agar were done. 62 [24.8%] CSF samples were culture negative and no bacterial organisms could be detected by direct gram stain. All these samples were further examined by latex agglutination and RT-PCR. Samples which found to be culture positive were excluded from this study. 15 samples of them [24.2%] were positive by RT-PCR.7 of them [46.6%] were Heamophilus influenza b [H. influenza b] and 8 samples of them [53.3%] were Streptcoccus pneumoniae [S. pneumoniae]. Out of 15 RT-PCR positive samples 12 of them [80%] were Latex positive, while 3 of them [20%] were Latex negative, one of the three was S. pneumoniae, while the others were H. influenza b by RT-PCR only. Out of 62 culture negative CSF samples 47 [75.8%] had a history of previous antibiotic use. 11samples of them [23.4%] were positive by latex agglutination [5 samples were H. influenza b and 6 samples were S. pneumonia] and 3 samples of them [6.3%] were positive by RT-PCR and negative by latex agglutination. Out of 15 RT-PCR positive samples, 8 of them were clear [53.3%], 3 of them were turbid [20%], and 4 of them were bloody [26.6%]. 10 CSF samples out of the 15 samples [66.6%] had normal cytological profile, 6 samples [40%] had normal CSF glucose levels and 3 samples [20%] had normal total CSF protein concentration