PROCALCITONIN MIGHT HELP IN DISCRIMINATION BETWEEN MENINGEAL NEURO-BEHcET DISEASE AND BACTERIAL MENINGITIS

Abstract

Neuro-Behcet disease sometimes mimics bacterial meningitis because the patients present with acute meningeal syndrome and show polymorphonucleic pleocytosis in the CSF.1 Here we report a case of recurrence of neuro-Behcet disease resembling bacterial meningitis (meningeal neuro-Behcet disease) and propose the usefulness of serum procalcitonin levels for discrimination between meningeal neuro-Behcet disease and septic meningitis. ### Case report. A 30-year-old man with intractable headache, high fever, and drowsiness (E3, V4, M6/GCS) was transferred to our hospital. He presented meningeal signs and bilateral papilledema. The laboratory data were leukocytes 19,400/μL (Seg 59%), C-reactive protein (CRP) 9.6 mg/dL, and serum amyloid A 448 μg/mL. He also showed polymorphonucleated leukocyte predominant pleocytosis and increased intracranial pressure (table, patient 1). He was suspected of having recurrent neuro-Behcet disease because of skin eruptions, uveitis, and aphtha. Furthermore, MRI fluid-attenuated inversion recovery images showed small high lesions in the brainstem, cerebral hemispheres, cerebral subcortical area, putamen, and left cerebellar hemisphere, compatible with neuro-Behcet disease. However, bacterial …