The Importance of Lactic Acid Levels in Body Fluids in the Detection of Bacterial Infections

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Abstract
Many data indicate that the measurement of lactic acid levels in body fluids is a rapid, reliable means of early differentiation between bacterial and nonbacterial inflammation in various body cavities. Elevated levels of lactic acid are detectable in patients with meningitis (levels in cerebrospinal fluid [CSF], >35 mg/100ml), septic arthritis (levels in synovial fluid, >65 mg/100ml), peritonitis (levels in peritoneal fluid >33 mg/100 ml), and pleural infection (levels in pleural fluid, >45 mg/100 ml). Falsely positive or falsely negative results may be achieved, however, in the measurement of lactic acid levels in patients with certain conditions. High levels of lactic acid may occur in the CSF of patients with diabetic coma, increased intracranial pressure, or cerebrovascular accidents, or in the peritoneal and pleural fluids of patients with metastases in these spaces. Low levels of lactic acid may be present in the CSF during the early stages of bacterial meningitis and in the joint fluid in gonococcal arthritis. Despite these exceptions, however, the measurement of the concentration of lactic acid in body fluids can be an important adjunct to the clinical assessment of patients suspected of having bacterial infections.

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