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

Pathophysiological studies in bacterial meningitis in man have been limited by clinical variability and the necessity for immediate therapy. After the development of a reliable animal model of pneumococcal meningitis, we studied respiration and circulation in 25 anesthetized New Zealand white rabbits during untreated pneumococcal meningitis and in 33 healthy controls. In meningitis, we found increased lactic acid in cerebrospinal fluid (CSF). Increased ventilation, perhaps due to CSF lactic acid accumulation, resulted in respiratory alkalosis; the concomitant lowering of Pco(2) acted as a homeostatic mechanism to restore pH toward normality in the CSF. Hyperventilation increased with the duration of the illness. Cardiac output was also increased with decreased peripheral vascular resistance but with only slight reduction in mean systemic and pulmonary arterial pressures. In the final hour of life, peripheral vascular resistance fell further; ventilation declined and then abruptly ceased while cardiac activity continued. Lactic acid accumulation in the CSF, found in both experimental and human pneumococcal meningitis, may cause the hyperventilation found in this disease and may contribute to death.
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PMID:Effect of experimental pneumococcal meningitis on respiration and circulation in the rabbit. 415 1

Analysis of cerebrospinal fluid lactic acid levels in 62 patients suspected of having meningitis was performed. Lactic acid was measured enzymatically using lactic acid dehydrogenase with the liberation of NADH. In a control (no meningitis) group, 46 children had a mean cerebrospinal fluid lactic acid level of 14.7 +/- 2.2 mg/dl; 3 with febrile seizure had a mean lactic acid level of 33.5 +/- 0.98 mg/dl. In 9 cases of bacterial meningitis, the mean lactic acid level was 54.8 +/- 16.8 mg/dl. In 3 patients of aseptic meningitis, the mean lactic acid level was 34.5 +/- 1.0 mg/dl. Serial lactate determination was done in three patients and they were well correlated with the clinical response and other cerebrospinal fluid findings. These data suggest that the determination of cerebrospinal fluid lactic acid may be of diagnostic value in differentiating between bacterial and aseptic meningitis.
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PMID:Diagnostic use of cerebrospinal fluid lactic acid levels in meningitis. 658 98

Lactic acid concentration has been determined in the cerebrospinal fluid (CSF) of 715 patients suffering from various neurological diseases. It was found to be most often elevated in cases of ischemic cerebral infarction, cerebral contusion, arteriosclerotic dementia, metastatic encephalitis, bacterial meningitis, menigiosis carcinomatosa and after epileptic seizures. In fewer cases lactate levels were increased with brain tumors, encephalitis, viral meningitis and radiculitis. Diagnostic relevance of CSF lactic acid determination is discussed with regard to ischemic cerebral disorders, differential diagnosis of viral and bacterial meningitis and for the confirmation of epileptic seizures.
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PMID:[Importance of cerebrospinal fluid lactate determination in neurological diseases]. 686 67

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

The stability of lactic acid in cerebrospinal fluid specimens from children with or without infections of the central nervous system was determined. Twenty-six patients were studied. These were ten children with bacterial meningitis, nine with aseptic meningitis and seven without any inflammation of the central nervous system. The specimens were left at room temperature and lactic acid concentration was measured at sequential intervals: 15 minutes, and two, six and 24 hours following their collection. A decline in the concentration was noticed in all specimens. However, the most marked total reduction in lactic acid concentration was noted in specimens obtained from patients with bacterial meningitis. The average reduction in that group was 5 mg/dl after two hours, 11 mg/dl after six hours and 18 mg/dl following 24 hours. Lactic acid concentration remained unchanged up to 72 hours in specimens frozen at -20 degrees C. To prevent misleading results, it is recommended that cerebrospinal fluid specimens not be left at room temperature for prolonged periods of time prior to lactic acid determination.
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PMID:Stability of lactic acid in cerebrospinal fluid specimens. 706 19

Cerebrospinal fluid (CSF) lactate was determined in 245 patients by means of a rapid enzymatic method (Monotest Lactate). The mean value was 1.61 mmol/l (range 0.79-3.33) in 104 control patients, 2.06 mmol/l (range 0.76-4.31) in 121 patients with aseptic meningitis, and 8.18 mmol/l (range 1.77-19.21) in 20 patients with bacterial meningitis. In most of the patients CSF protein and the CSF/blood glucose quotient were also determined. Lactate and glucose quotient differentiated equally well between aseptic and bacterial meningitis while protein was somewhat less useful. Suitable values for discrimination between aseptic and bacterial meningitis were judged to be 3.0 mmol/l for CSF lactate, 1.0 g/l for CSF protein and 0.5 for the glucose quotient. Combinations of tests improved the diagnostic accuracy in aseptic but not in bacterial meningitis. In 2 patients with bacterial meningitis all tests failed. CSF lactate may be used as a supplementary aid in the diagnosis of meningitis. Its diagnostic efficacy was equal to but not better than that of the traditional methods.
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PMID:Cerebrospinal fluid lactate in the diagnosis of meningitis. Diagnostic value compared to standard biochemical methods. 710 Aug 21

The cytological and biochemical examination of cerebrospinal fluid (CSF) has been used for the presumed diagnosis of bacterial meningitis until the final microbiological results are achieved. We assessed the ability of CSF lactate in comparison with other CSF parameters to discriminate bacterial and enteroviral community acquired meningitis. We included 1,187 CSF samples of acute community-acquired meningitis, being 662 cases of bacterial and 525 of enteroviral meningitis. Lactate concentration (mg/dL), leukocyte count/mm3, protein (mg/dL), and glucose (mg/dL) were compared between bacterial and viral meningitis. Receiver operator characteristic (ROC) curves were used to assess diagnostic performance. CSF leukocytes, CSF protein and CSF lactate were significantly higher in bacterial meningitis cases (P<0.0001). CSF glucose was significantly lower in bacterial meningitis cases (P<0.0001). CSF lactate showed the best predictive ability with an area under the curve of 0.944 (95% CI 0.929 - 0.959). Considering a cut off of CSF lactate of 30 mg/dL, the sensitivity and specificity for bacterial meningitis were 84.1% and 99%, respectively. In the cytological and biochemical CSF analysis, CSF lactate was the most accurate marker for bacterial meningitis.
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PMID:Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis. 3101 85


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