From the Dept. of Medical Biochemistry, Iran University of Medical Sciences, Tehran, I.R. Iran,
Abstract: (4676 Views)
Despite recent innovations in the laboratory diagnosis of bacterial from nonbacterial
meningitis, solid data-necessary for early determination of bacterial meningitis
(BM) before organism growth in the culture medium-are missing. Therefore
cerebrospinal fluid (CSF) lactate levels were evaluated as a possible means
of differentiating the two clinical entities. This was a retrospective study. Patients
were studied in one year. They were divided into three groups: Group one included
10 patients with culture positive meningitis Group two included 10 patients
with culture negative meningitis compatible with a viral etiology Group
three consisted of 10 febrile children without any biochemical or cytological CSF
abnormality as the normal controls.
CSF lactate level determinations were made enzymatically with Boehringer
Mannheim reagents in addition to the formal biochemical and cytological investigations,
consisting of cell counts and differential plus glucose and protein levels
and CSF/blood glucose ratio in all three groups. Group one had a mean CSF
lactate level of 12.90 (±3.08) mmol/L, while in groups 2 and 3 the level was 1.89
(± 0.52) mmoL/l and 1.63 (±0.31) mmol/L respectively. Lactate levels were significantly
higher in patients from group one with respect to the control group (p=
0.001) whereas there were no significant differences between group 2 and the
control group. Regarding temporal profile of CSF markers and considering the
rapid rise in CSF lactate levels in bacterial meningitis, its measurement seems
appealing to confirm a bacterial etiology instead of awaiting the results of CSF
culture.