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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To assess the reliability of cerebrospinal fluid (CSF) lactate levels in children for differentiating between bacterial and viral meningitis, we measured the CSF lactate levels using the carboxylic acid analyzer, enzymatic method and colorimetric determination. Lactate determination by these methods is a highly reliable indicator of the presence or absence of bacterial meningitis. Moreover, the duration of elevated CSF lactate levels coincided with the clinical response to therapy.
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PMID:The diagnostic value of cerebrospinal fluid lactic acid levels in meningitis. 702 97

Levels of amikacin after systemic application of 350 mg were determined by the agar well diffusion method in 12 samples of CSF and serum of 7 patients with bacterial meningitis and in 2 samples of 2 patients with viral meningitis. Only in 2 samples of CSF drawn after the first systemic application of 350 mg i.m. no antibiotic activity was detectable. In 7 specimens of CSF levels of amikacin were greater than or equal to 3 microgram/ml. In 12 tests of CSF of neurosurgical patients with only slight impairment of the blood-CSF-barrier, taken for comparison reasons, only in 6 samples antibiotic activity was found. Only one test revealed CSF-concentration of amikacin higher then 3 microgram/ml.
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PMID:[CSF levels of amikacin following systemic application in patients with slightly and severely impaired blood cerebrospinal barrier (author's transl)]. 706 69

A local defense mechanism in bacterial meningitis was evaluated in humans by measuring complement-mediated opsonic activity (CMOA) in normal and infected cerebrospinal fluid (CSF) with a complement-dependent phagocytic bactericidal assay. CMOA was absent in normal untreated CSF and remained undetectable in 20 samples of CSF from patients with viral meningitis and five samples from patients with acute meningococcemia. In contrast, 15 of 27 samples of CSF from patients with acute bacterial meningitis had a measurable CMOA, which was correlated with protein concentrations (P less than 0.01) and C4 hemolytic activity (P less than 0.001) in the CSF. A favorable outcome of bacterial meningitis was associated with the presence of CMOA in CSF (P less than 0.005). Recovery was also correlated with higher levels of C4 (P less than 0.01) and C3 (P less than 0.05) in CSF and with lower concentrations of microorganisms in the sample of CSF collected at the time of admission (P less than 0.01). Thus, CMOA, although absent in normal CSF, can appear in CSF during acute bacterial meningitis, particularly in patients who recover completely.
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PMID:Complement-mediated opsonic activity in normal and infected human cerebrospinal fluid: early response during bacterial meningitis. 707 88

A rapid, microenzymatic method was used to measure cerebrospinal fluid lactate levels in 205 children with suspected bacterial meningitis. Fifty children with normal CSF containing fewer than 0.005 X 10(9)/l WBC, no segmented neutrophils, glucose 3.4 +/- 0.8 mmol/l (61.2 +/- 14.4 mg/100 ml), and a protein of less than 0.30 g/l had CSF lactate levels below 2.0 mmol/l (18 mg/100 ml) (mean and standard deviation 1.3 +/- 0.3 mmol/l (11.8 +/- 2.7 mg/100 ml)). In 31 cases of proved viral meningitis as with 58 cases of clinically diagnosed viral meningitis, levels were below 3.8 mmol/l (34.5 mg/100 ml), being 2.3 +/- 0.6 mmol/l (20.9 +/- 5.4 mg/100 ml), and 2.1 +/- 0.7 mmol/l (19.1 +/- 6.4 mg/100 ml) respectively. Sixty-six cases of bacterial meningitis had CSF lactate levels ranging from 3.9 mmol/l (35.4 mg/100 ml) to greater than 10.0 mmol/l (90.0 mg/100 ml). Longitudinal studies in 7 children with bacterial meningitis showed that cerebrospinal fluid lactate levels differentiated bacterial from viral meningitis up to 4 days after starting treatment with antibiotics. Use of CSF lactate measurement for monitoring the efficacy of treatment is illustrated in a case of bacterial meningitis due to Pseudomonas aeruginosa. The origin of the cerebrospinal fluid lactate acidosis and the role of lactate in the pathophysiological cycle leading to intensification of brain tissue hypoxia and cellular damage is discussed with respect to the short-term prognosis and the long-term neurological sequelae.
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PMID:Cerebrospinal fluid lactic acidosis in bacterial meningitis. 729 72

The level of lactic acid in cerebrospinal fluid has been 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 greater than or equal to 35 mg/dl, determined by either gas-liquid chromatography or an enzymatic method, has been considered in several studies to provide definite evidence of meningitis of bacterial origin, whereas a lower level indicates no bacterial involvement. Over the past 18 months, we have analyzed by the enzymatic method the lactate level in 493 spinal fluids submitted from 434 adult patients with various conditions involving the central nervous system. Fifty fluids had a lactate level of greater than 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 three cases of infective meningitis, of which two were cryptococcal and one was bacterial. In this adult study, the lactate level in the cerebrospinal fluid 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.
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PMID:Evaluation of cerebrospinal fluid lactic acid levels as an aid in differential diagnosis of bacterial and viral meningitis in adults. 737 96

Authors report results of treatment of 295 cases of CNS infection, of which 220 were bacterial meningitis and 75 viral meningitis. Positive cultures wre obtained in 62% of bacterial meningitis (122 "Neisseria meningitidis", eight "Pneumococci", three "Haemophylus influenzae" type B and three "M. tuberculosis"). Mortality in bacterial meningitis was 9%, and only 2% in viral meningitis. The main epidemiological, clinical and laboratory data are discussed.
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PMID:[Infections of the central nervous system. A review of 295 cases (author's transl)]. 740 62

The diagnostic value of determining phosphohexose isomerase (PHI, E.C. 5.3.1.9) activity in the CSF for differential diagnosis of bacterial and viral meningitis was investigated. In 29 patients with untreated bacterial meningitis, a mean enzyme activity of 511 U/1 was found, whereas a value 19 U/1 was found in 61 cases of viral meningitis. The reference range with an upper limit of 6 U/1 was determined from CSF samples from 163 "healthy" children. The high diagnostic sensitivity and specificity of 100% and 99.5% respectively make PHI a sensitive differential diagnostic parameter in meningitis.
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PMID:Phosphohexose isomerase in cerebrospinal fluid in meningitis. 740 13

Using the method of Park et al. the author studied spontaneous and stimulated NBT reduction by neutrophil granulocytes in the cerebrospinal fluid and blood, and by monocytic-reticular cells in the cerebrospinal fluid of the patients with bacterial and viral meningitis and meningismus. The author performed 333 investigations in 74 patients. Significantly higher mean values of the index of spontaneous and stimulated NBT reduction by the granulocytes and cerebrospinal fluid were observed in cases of bacterial meningitis as compared with the granulocytes of the peripheral blood in healthy subjects. It was demonstrated that in patients with bacterial meningitis blood and fluid granulocytes showed a similar phagocytic acitivty independent of the humoral environment. In the patients with bacterial and viral meningitis the monocytic-reticular cells the cerebrospinal fluid showed a similar, sometimes high, phagocytic activity depending on the phase and severity of the disease. On the otherhand, in most cases of meningismus these cells failed to manifest any phagocytic and bactericidal activity. In only few isolated cells in the fluid weak NBT reduction was observed. The obtained results of investigations showed the usefulness of the NBT test not only for the differential diagnosis of the aetiology of neuroinfections but also for the assessment of immune processes taking place in the nervous system.
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PMID:[Nitroblue tetrazolium reduction by the neutrophils of the cerebrospinal fluid and peripheral blood and by the monocytic-reticular cells of the cerebrospinal fluid in neuroinfections]. 741 90

Usefulness of N.B.T.-test (absolute values and percentages) has been tested in the diagnosis of "acute meningitis" in pediatric age. A total of 210 children of different ages have been divided in 3 groups: group A, consisting of 105 children with bacterial meningitis. Group B, 36 children with viral meningitis and group C formed by 69 health children. Differences between groups A and B were statistically significant (p less than 0.001) on both percentage and absolute values, while they were non-significant (p less than 0.001) on both percentage and absolute values, while they were non-significant between B and C groups. On serial controls of N.B.T. test percentage value during follow-up of the disease, a progressive normalization was observed which authors think had value for evaluation of the efficacy of the treatment as well as for prognostic significance. Results were tabulated on the normogram of Feign et al., with significant areas for each group.
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PMID:[N.B.T.-test in diagnosis of paediatric bacterial meningitis (author's transl)]. 741 39

The radioactive 82Br partition test was performed on 83 children with suspected tuberculous meningitis. Three of 51 patients with a final diagnosis of TBM had a false negative serum to CSF bromide partition ratio of more than 1.6. Four of the 32 patients in whom TBM was excluded had a false positive ratio of less than 1.6; three of these had sever purulent bacterial meningitis. The test distinguishes TBM from viral meningitis. Antituberculous therapy does not affect the diagnostic value of the bromide partition test in the first few weeks of treatment of TBM.
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PMID:The radioactive bromide partition test in the diagnosis of tuberculous meningitis in children. 743 Nov 82


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