Background and Objectives: Viral meningitis presents significant diagnostic challenges. The aim of this study was to identify predictive factors for meningitis etiology and clinical outcomes. Methods: This prospective, single center, comparative study enrolled patients meeting clinical, biological, and microbiological criteria for bacterial (BM) or viral (VM) meningitis. Serum inflammatory markers, namely the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were quantified. In addition, the concentrations of oxidative stress biomarkers, glutathione peroxidase 3 (GPx3) and copper/zinc superoxide dismutase (Cu/Zn SOD), were also determined. Spearman correlation and logistic regression were used to evaluate associations between biomarkers and etiology, while receiver operating characteristic (ROC) curves assessed outcome correlations. Results: VM patients showed a significantly lower NLR (p = 0.007), PLR (p = 0.010), and SII (p = 0.016), with higher GPx3 (p < 0.0001) levels compared with BM patients. Cu/Zn SOD showed no significant difference (p = 0.442) between groups. Multivariate logistic regression identified the SII (OR = 1.015; 95% CI = 1.004–1.026) and GPx3 (OR = 0.847; 95% CI = 0.740–0.970) as etiology predictors. The SII was the strongest predictor of mortality in VM (AUC = 0.833). Conclusions: Serum markers of inflammation, including the systemic immune–inflammation index, along with antioxidant indicators such as GPx3, may serve as valuable additional tools for predicting meningitis etiology and forecasting patient outcomes.
Enache-Leonte et al. (Fri,) studied this question.
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