الفهرس 
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Abstract
Bacterial meningitis is a serious type of meningoencephalitis that causes inflammation of meninges of the brain, particularly the arachnoid and piamater. Apart from meningeal inflammation, it has also been shown to affect other regions of the central nervous system (CNS). It has serious complications for producing detrimental long term clinical manifestations and life threatening consequences in comparison to viral meningitis Positive culture of cerebrospinal fluid for the bacterial agent, Gram staining, or presence of specific bacterial antigens in the CSF is considered the gold standard test for the diagnosis of bacterial meningitis in children. They have a high specificity but the sensitivity is poor. In addition, blood culture results require few days to become available To overcome the drawbacks of culture, there are new available biomarkers either in blood or CSF. The current work was performed to assess accuracy of serum PCT, CRP, LDH and CSF-CRP and multiplex PCR in differentiation between bacterial and viral meningitis in children. The study was conducted in period between November 2019 and September 2020. All children with clinically suspicious of meningitis were recruited All enrolled patients were subjected to full history taking and detailed physical examination. Complete blood picture, kidney function test, LDH and CRP was done in all patients. Lumbar puncture was done in a complete septic condition. CSF was physically and chemically examined Also, CSF culture was done in addition assessment level of CRP in CSF This study enrolled 48 children between age of 2 and 9 years. Those children were presented with clinical manifestation was consistent with meningitis. Mean age of those patients 3.27 ± 1.27 years, 29 patients (60.4%) were males while the other 19 patients (39.6%) were females.Where, presentation with fever present in all patients while in 43 (89.6%) and 38 (79.2%) patients had disturbed conscious level and convulsions, respectively Culture of CSF was positive in only 20 samples (41.6%) with different organisms from 48 enrolled patients where, the commonest organism was streptococcus pneumoniae (18.8%)Based on CSF analysis; the majority of the patients, 20 patients (62.5%) had bacterial meningitis while 12 patients (37.5%) had viral meningitis, Bacterial meningitis was either definite in 20 patients (41.7%) or probable in15 patients (31.3%). It was noticed that mean age of patients with viral meningitis was significantly lower than those with bacterial meningitis Also, the current study revealed that patients with bacterial meningitis had significantly higher serum CRP, PCT, LDH, CSF-CRP and lower CSF/blood glucose ratio than those with viral meningitis. Protein, total cells count and neutrophils were higher also, in patients with bacterial meningitis.