DISTURBANCES OF IONIC EQUILIBRIUM OF INTRACELLULAR AND EXTRACELLULAR ELECTROLYTES IN PATIENTS WITH TUBERCULOUS MENINGITIS 1

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Abstract
Studies of the concns. of electrolytes in the plasma, red blood cells, and skeletal muscle of children with tuberculous meningitis revealed a characteristic disturbance in the electrolyte pattern of the intracellular and extracellular fluids. During active infection the concns. of Na and Cl in plasma are lowered without consistent change in K or HCO3-. In the red blood cell water there is an increase in the concn. of Na with no change in the level of K. In skeletal muscle there is an increase of Na and a decrease of K content. K/N and Na/Cl ratios indicate that in the muscle the changes represent an intracellular depletion of K with a concomitant rise in intracellular Na. During clinical remission the concns. of Na and of Cl in plasma and of Na in red blood cell water return to the normal range. The mechanism for these changes in electrolytes during severe tuberculous infections is not known, but interpretations which fit in with current theories of ionic equilibrium between cells and extracellular fluid are suggested.

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