Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We conducted a study to assess the efficacy of the dipstick leukocyte esterase test (LET) in the detection of cerebrospinal fluid (CSF) leukocytosis as a quick screen for bacterial meningitis. Nine hundred forty-two CSF samples were collected from 800 patients. The LET was compared in a double-blinded fashion with routine cell count determinations and cultures. We reviewed the clinical courses of all patients with positive cultures to assess the significance of culture isolates. Statistical analysis revealed LET sensitivity of 84.4% and specificity of 98.1% for clinical presentations of bacterial meningitis for which initiation of therapy is currently recommended. The LET identified culture-proven cases of meningitis with sensitivity of 73% and specificity of 95%. We propose the LET as an adjunct to, but not a replacement for, CSF cell count and chemistry determination in the initial laboratory assessment of bacterial meningitis. It is a reasonable screen that allows rapid initiation of treatment and directs the laboratory technician to devote extra attention to examination of a CSF specimen with a higher likelihood of pathology.
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PMID:The leukocyte esterase test for detection of cerebrospinal fluid leukocytosis and bacterial meningitis. 268

Mono-histiocytes and T-lymphocytes were assessed by the cytochemical alpha-naphthyl-acetate-esterase (ANAE) stain in 50 CSF samples of patients with various neurological diseases. The ANAE-activity of lymphocytes was decreased in multiple sclerosis and subacute sclerosing panencephalitis, while the activity of mono-histiocytes was increased in the group of infarctions and bacterial and viral infections of the central nervous system. In bacterial meningitis and viral meningo-encephalo-radiculitis the number of ANAE-positive lymphocytes increased after treatment and clinical improvement. ANAE staining appears to be a useful additional tool in CSF cytology in these conditions.
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PMID:Alpha-naphthyl-acetate-esterase activity in cerebrospinal fluid cells. 326 33

The Chemstrip-L test was evaluated in 249 body fluids for its ability to detect leukocytes. Three of 42 cerebrospinal fluids were positive for leukocyte esterases, of which all three were cases of culture-confirmed bacterial meningitis. After the addition of predetermined numbers of neutrophils, the lowest level of detection of neutrophils in cerebrospinal fluids was 40 per microliter. Seventy-five of 200 (38%) peritoneal fluids had positive leukocyte esterase tests. Sixty-six of 72 (89%) peritoneal fluids with 100 or greater neutrophils per microliter had positive leukocyte esterase tests. Protein content, if increased, may interfere with the results of the L-test.
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PMID:Correlation of leukocyte esterase detection and the presence of leukocytes in body fluids. 706 89

Urine reagent strips have been used to test cerebrospinal fluid (CSF) in areas where laboratory facilities are unavailable. Protein, glucose and leukocyte esterase patches have been shown to be useful in this context. We propose that the nitrite patch also has a contribution to make: it could provide clinically useful information, at no extra cost. We tested CSF samples from 200 children with suspected meningitis. In a pragmatic approach chosen to reflect the clinical dilemma of whether or not to use parenteral antibiotics, the final laboratory diagnosis was dichotomized into either 'bacterial meningitis' or 'not bacterial meningitis'. These diagnostic categories were compared with nitrite patch results, which were either positive or negative. Nitrite patch testing of all CSF, clear CSF and bloody CSF gave positive likelihood ratios of 49, 'infinity' and 5.8, respectively.
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PMID:Rapid diagnosis of bacterial meningitis using nitrite patch testing. 1551 Sep 53