Background: Rapid and accurate diagnosis of patients with suspected
bacterial meningitis (BM) is crucial to prevent potential subsequent mortality and
morbidity. The aim of this study was to explore the diagnostic value of the rapid leukocyte
esterase (LE) strip test in identifying pleocytosis in cerebrospinal fluid (CSF)
samples of patients with suspected BM.
Methods: A total of 126 patients with suspected meningitis were enrolled in this prospective
study. Microscopic examination (cell count and differential) and leukocyte
esterase (LE) rapid strip test were performed on cerebrospinal fluid (CSF) samples.
Sensitivity, specificity, positive predictive value and negative predictive value of the
LE test were determined.
Results: Fifty-two patients (41%) had pleocytosis in the CSF, while 48 (38%) patients
had a positive rapid LE strip test result. The diagnostic accuracy of this test for
pleocytosis was translated to a sensitivity of 84.6% (95%CI 71.9, 93.1) and a specificity
of 94.5% (95%CI 86.7, 98.5), with an area under the receiver operating curve
Conclusion: The LE strip test, through rapid and accurate determination of CSF pleocytosis,
could be considered as an additional test in the diagnosis of bacterial meningitis.
It can be tested at bedside and is feasible to do in resource-limited settings.