TUBERCULOUS MENINGITIS: THE DIAGNOSTIC AND PROGNOSTIC SIGNIFICANCE OF SPINAL FLUID SUGAR AND CHLORIDE

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Abstract
A series of 231 cases of tuberculous meningitis observed at the Los Angeles County General Hospital was analyzed to ascertain the diagnostic and prognostic significance of the spinal fluid sugar and chloride levels. Both factors were depressed in most instances, but in a significant number of cases one or the other was normal at the time of the initial examination and remained so throughout the diagnostic period. In this series the sugar levels failed to reflect the meningeal tuberculosis more often than did that of the chloride. Neither the spinal fluid glucose nor chloride provided a sensitive prognostic index. But again, of the two we found the chloride level to be somewhat more reliable. The advisability of routine spinal fluid glucose determinations as an aid in diagnosis is recognized quite generally. Opinion as to the desirability of routinely measuring the chloride levels is divided. It is suggested that both sugar and chloride level determinations be part of the routine spinal fluid analysis in tuberculous meningitis.