C-reactive protein as a detector of organic complications during recovery from childhood purulent meningitis.

Twenty-eight bacteriologically proved episodes of purulent meningitis in 27 infants and children were monitored prospectively with sequential determinations of serum C-reactive protein. Except in one rapidly fatal case, all the patients showed decreasing CRP values for about 1 week. In five patients the CRP values than returned to a high level (P less than 0.001). Each of these patients developed an organic complication (subdural effusions in three, transient widening of the ventricles in one, purulent arthritis with osteomyelitis in one). Except for one infant with sensorineural hearing loss, which probably had developed early in the course of meningitis, no permanent sequelae were found in the patients with uncomplicated courses. One infant later had a relapse of Escherichia coli meningitis, reflected in a sharp increase of CRP. We conclude that sequential CRP measurements may be performed routinely to detect potential complications at an early stage of bacterial meningitis.