Predictive Value of Cerebrospinal Fluid (CSF) Lactate Level vs CSF-Blood Glucose Ratio for the Diagnosis of Bacterial Meningitis Following Neurosurgery

April 2, 2019 at 6:13 pm

Clinical Infectious Diseases July 1999 V.29 N.1 P.69-74

Stephen L. Leib; Remy Boscacci; Othmar Gratzl; Werner Zimmerli

The value of cerebrospinal fluid (CSF) lactate level and CSF/blood glucose ratio for the identification of bacterial meningitis following neurosurgery was assessed in a retrospective study. During a 3-year period, 73 patients fulfilled the inclusion criteria and could be grouped by preset criteria in one of three categories: proven bacterial meningitis (n = 12), presumed bacterial meningitis (n = 14), and nonbacterial meningeal syndrome (n = 47). Of 73 patients analyzed, 45% were treated with antibiotics and 33% with steroids at the time of first lumbar puncture. CSF lactate values (cutoff, 4 mmol/L), in comparison with CSF/blood glucose ratios (cutoff, 0.4), were associated with higher sensitivity (0.88 vs. 0.77), specificity (0.98 vs. 0.87), and positive (0.96 vs. 0.77) and negative (0.94 vs. 0.87) predictive values. In conclusion, determination of the CSF lactate value is a quick, sensitive, and specific test to identify patients with bacterial meningitis after neurosurgery.

FULL TEXT

https://academic.oup.com/cid/article/29/1/69/323396

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Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Biología Molecular, BIOMARCADORES, Epidemiología, FIEBRE en el POSTOPERATORIO, Health Care-Associated Infections, Infecciones del SNC, Infecciones nosocomiales, Infecciones relacionadas a prótesis, Infecciones sitio quirurgico, Metodos diagnosticos, REPORTS, Resistencia bacteriana, Sepsis.

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