Evaluation of cerebrospinal fluid lactic acid levels as an aid in differential diagnosis of bacterial and viral meningitis in adults

Publisher Website
Google Scholar
Abstract
The level of lactic acid in CSF was suggested as a useful diagnostic parameter to differentiate between bacterial and viral meningitis, especially in patients partially treated before admission to hospital. A concentration of .gtoreq. 35 mg/dl, determined by GLC or an enzymatic method, was considered in several studies to provide definite evidence of meningitis of bacterial origin; a lower level indicates no bacterial involvement. Over the past 18 mo. the lactate level in 493 spinal fluids submitted from 434 adult patients with various conditions involving the CNS was analyzed by the enzymatic method. Fifty fluids had a lactate level of > 35 mg/dl, of which 19 were cases of infective meningitis of varying etiology. The 435 specimens with lactate levels within the range considered normal included 3 cases of infective meningitis, of which 2 were cryptococcal and 1 was bacterial. In this adult study, the lactate level in the CSF did not provide unequivocal evidence of bacterial infection and did not provide assistance to any greater degree than the standard parameters of leukocyte count, protein and glucose contents in the differential diagnosis of bacterial meningitis from that of any other etiology.