Aim: In our study we observed that changes in the findings of CSF differs and increase in the protein content of the CSF in particular varies with the types of meningitis. The study was aimed at finding the relationship of the range of elevation of protein with different types of meningitis.

Methodology: Total 40 subjects were included in this study. The subjects were selected from the patients admitted in the Pediatric in-patient department of the Chattagram Ma-Shishu O General Hospital Medical College, Chittagong and Bangladesh. This study was done during the period of November 2008 to June 2009. Among the cases, preceding other infections were very high eg Pneumonia was present in 15, Measles in 2, Tuberculosis in 5 cases and preceding Seizure disorder was present in 4 cases. Most of the patients had the features of meningism, ie Neck rigidity was positive in 30%, Kernig sign in 22%, and Brudziniski sign in 24% patients respectively. Pyogenic meningitis was diagnosed in 68%, viral meningitis in 12% of the patients and Tubercular meningitis was clinically diagnosed in 2 patients.

Results: The protein level was significantly increased (> 80mg/dl) in 65%, moderately increased (61-80mg/dl) in 20% and mildly increased (46-60mg/dl) in 15% of the patients. Patients with Pyogenic meningitis and Tubercular meningitis had significantly increased protein level (> 240mg/dl) in their CSF whereas in viral meningitis the CSF protein level is highly variable and in between 62-178.3 mg/dl. Furthermore, lymphocyte and neutrophils were also detected in the CSF of 5 (12.5%) and 34 (85%) of the patients respectively. In pyogenic meningitis, the Neutrophil count was very high compared to that in viral meningitis-the finding which helps in disease management.

Conclusion: The study demonstrates that protein level in CSF might be a potential tool for detecting and differentiating different types of meningitis more precisely.