Cerebrospinal fluid lactate and lactate dehydrogenase activity in the rapid diagnosis of bacterial meningitis
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The value of cerebrospinal fluid (CSF) lactate and lactate dehydrogenase (LD) activity in the rapid diagnosis of meningitis was investigated in three groups of patients - a 'no meningitis', an aseptic meningitis and a bacterial meningitis group. The sensitivity achieved in the detection of bacterial meningitis by CSF lactate values of 2,85 mmol/l (93,8%) and 3,9 mmol/l (89,6%) was greater than that reached by conventional chemical investigations using a CSF protein value of 1 g/l (81,5%) or a CSF glucose value of 2,2 mmol/l (68,8%) as the indicator. The sensitivity of an absolute CSF LD value of 40 U/l (86,3%) in the detection of bacterial meningitis was slightly lower than that of a CSF protein value of 1 g/l (87%) and better than the sensitivity of either a CSF/serum LD ratio of 0,1:1,0 (83,9%) or a CSF glucose level of 2,2 mmol/l (76,3%). As with conventional CSF chemistry, both investigations may give normal values in the presence of bacterial meningitis.
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