Analysis and Diagnostic Significance of Cerebrospinal Fluid Laboratory Parameters in Patients with Post-Craniotomy Meningitis.

Authors

Yuan Xu, Hong Yu, Juan Chen, Yaoyao Tong, Yue Chen, Yali Wang, Ying Liang, Shimin Wu

Published in

Clinical laboratory. Volume 72. Issue 6. Jun 01, 2026.

Abstract

Post-craniotomy meningitis (PCM) is a common and serious infectious complication in neurosurgical practice, often associated with considerable morbidity and healthcare burden. Due to the lack of specificity in its clinical manifestations, early diagnosis remains a significant challenge. Although cerebrospinal fluid (CSF) culture is currently regarded as the diagnostic gold standard, its effectiveness is limited by stringent pathogen growth requirements and a relatively low positivity rate, rendering it insufficient to meet clinical needs. Therefore, this study aimed to evaluate the diagnostic value of routine and biochemical CSF parameters in the early identification of PCM.
A retrospective analysis was conducted on clinical data and CSF test results of 588 PCM patients admitted to our hospital from January 2019 through December 2023. Based on CSF culture results, patients were divided into a culture-positive group (n = 49) and a culture-negative group (n = 539). The distribution of major pathogens was analyzed, and differences in general clinical characteristics as well as routine and biochemical CSF parameters between the two groups were compared. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of relevant parameters for predicting CSF culture positivity.
Significant differences were observed between the two groups in terms of gender, history of tumor or traumatic brain injury, ICU admission rate, CSF leakage, and external ventricular drainage (p < 0.05), suggesting that these factors may be associated with CSF culture positivity. The most frequently isolated pathogens in the positive group were Acinetobacter baumannii, Staphylococcus aureus, and Staphylococcus hominis. Regarding lab-oratory findings, the culture-positive group showed significantly higher polymorphonuclear cell counts, mononuclear cell counts, total white blood cell counts, and CSF total protein levels compared to the negative group (p < 0.05). ROC analysis revealed good diagnostic performance of these parameters, with AUC values of 0.9398, 0.8516, 0.8687, and 0.7048, respectively. The combined detection of these indicators further improved diagnostic accuracy, with an AUC of 0.9821, significantly outperforming individual parameters.
Routine and biochemical CSF parameters hold significant clinical value for the early identification of PCM. In particular, elevated polymorphonuclear and mononuclear cell counts, total white blood cell counts, and CSF total protein levels are potentially sensitive markers for early screening.

PMID:
42295295
Bibliographic data and abstract were imported from PubMed on 15 Jun 2026.

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