New and old diagnostic markers of meningitis in cerebrospinal fluid (CSF)

Kleine, T. O.; Zwerenz, Peter; Zöfel, P.; Shiratori, Kiyoshi

doi:10.1016/s0361-9230(03)00092-3

Cited by 69 publications

(47 citation statements)

References 34 publications

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“…This is because bacterial meningitis is a life-threatening disease and has a much poorer prognosis compared with viral meningitis. Since bacterial meningitis can be cured successfully in the early phase of the disease, tests are needed to diagnose bacterial meningitis accurately and reliable with high-sensitivity and specificity (12). Lactate concentrations are particularly important when the CSF Gram stain is negative and there is a predominance of polymorphonuclear cells and low CSF glucose concentrations (2,14).…”

Section: Figure 1 Csf Lactic Acid (Mmol/l) Concentration In the Studimentioning

confidence: 99%

“…This limit proved to also be relevant for tuberculosis (38), Listeria monocytogenes (39) and fungal meningitis (40). A higher discrimination limit of )5.0 mmol/L diminished diagnostic sensitivity, while a lower limit of 2.8 mmol/L decreased diagnostic specificity and did not allow to distinguish viral meningitis from controls (12). CSF glucose is considered by clinicians to be a good marker to discriminate acute bacterial meningitis from viral meningitis.…”

Section: Figure 1 Csf Lactic Acid (Mmol/l) Concentration In the Studimentioning

confidence: 99%

“…CSF lactic acid (LA) is considered a good biomarker for differentiating bacterial from viral meningitis at a cut-off of 3.5 mmol/L (8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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Quantitation of cerebrospinal fluid lactic acid in infectious and non-infectious neurological diseases

Almeida

Faria

Fontes

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: The differential diagnosis between bacterial and viral meningitis is not easy in some cases. Cerebrospinal fluid (CSF) analysis is essential for establishing this diagnosis. The objectives were to quantitate lactic acid (LA) concentrations in bacterial and viral meningitis, and other central nervous system (CNS) diseases in order to evaluate the diagnostic utility of CSF LA for discriminating bacterial from viral meningitis. Methods: CSF LA was measured in 139 CSF samples from seven groups: viral meningitis with classic CSF; suspicion of viral meningitis with neutrophils in CSF; bacterial meningitis; non-infectious neurological diseases; chronic meningitis; traumatic lumbar puncture (LP) and normal CSF. Results: CSF LA was higher in bacterial meningitis 8.7q5.4 mmol/L compared with viral meningitis (1.9q0.6) and the other groups (p-0.0001). CSF LA in the groups with viral meningitis was not different compared to groups with non-infectious CNS diseases and chronic meningitis. The ability of CSF LA to discriminate bacterial from viral meningitis showed a sensitivity of 80% and specificity of 97%, positive predictive value (PPV) of 94%, and negative predictive value (NPV) of 89%. Conclusions: CSF LA is a powerful test to discriminate bacterial from viral meningitis with high sensitivity,

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Section: Figure 1 Csf Lactic Acid (Mmol/l) Concentration In the Studimentioning

confidence: 99%

Section: Figure 1 Csf Lactic Acid (Mmol/l) Concentration In the Studimentioning

confidence: 99%

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Quantitation of cerebrospinal fluid lactic acid in infectious and non-infectious neurological diseases

Almeida

Faria

Fontes

et al. 2009

Clinical Chemistry and Laboratory Medicine

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“…Within the enterovirus group, there is an important further division into the Picornaviridae family: Echovirus [4,5,7,10,12,16,22,31], the Polioviruses and the Coxsackieviruses of groups A and B 1,2. Enterovirus numbers 70 and 71 show a strong neurotropism, which is associated with meningoencephalitis, polio-like paralytic syndromes, Guillain Barré Syndrome, as along with meningitis.…”

Section: Lymphocytic Meningitis With Infectious Etiology Viral Meningmentioning

confidence: 99%

Laboratorial diagnosis of lymphocytic meningitis

Nogueira

et al. 2007

Braz J Infect Dis

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Meningitis is the main infectious central nervous system (CNS) syndrome. Viruses or bacteria can cause acute meningitis of infectious etiology. The term "Aseptic Meningitis" denotes a clinical syndrome with a predominance of lymphocytes in the cerebrospinal fluid (CSF), with no common bacterial agents identified in the CSF. Viral meningitis is considered the main cause of lymphocyte meningitis. There are other etiologies of an infectious nature. CSF examination is essential to establish the diagnosis and to identify the etiological agent of lymphocytic meningitis. We examined CSF characteristics and the differential diagnosis of the main types of meningitis.

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“…Cellular and biochemical CSF characteristics -Little attention has been given to the routine analysis of the CSF and its relationship to the clinical data on tumoral pathology 15,16,[25][26][27][28][29] . our data showed that total CSF cell count was greater in the group with malignant cells than the group without malignant cells, consisting predominantly of lymphocytes and monocytes and in some cases neutrophils supporting reports from other studies 15,16 .…”

Section: Grünwald/giensa Stain 1000x) the Cell Borders Are Irregulmentioning

confidence: 99%

Cerebrospinal fluid cytological and biochemical characteristics in the presence of CNS neoplasia

Almeida

Nanakanishi

Conto

et al. 2007

Arq. Neuro-Psiquiatr.

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-Central nervous system (CNS) infiltration must be ruled out in patients with known neoplastic diseases and neurological symptoms. It was done a retrospective analysis of 1,948 CSF samples from patients with suspected malignant infiltration in the CNS, in order to evaluate the positivity rate of malignant cells in cerebrospinal fluid (CSF) samples and correlate with cytochemical characteristics. Sixty-two percent of subjects had acute lymphocytic leukemia. Malignant cells were found in 24% of all CSF samples. Subjects with positive malignant cells had predominance of increased levels of CSF total protein (TP), glucose and total cytology (p<0.05). Mean total cell count in this group was 232 (SD 933) cells/mm 3 , compared to 9 (SD 93) cells/mm 3 in the group without neoplasic cells (p=0.029). CSF TP specificity was 87% and negative predictive value (NPV) 96%. CSF total cell count specificity 86% and NPV 97%. Although sensitivity and positive predictive value were low. The presence of inflammatory cells and elevated TP found in patients with malignant cells in the CSF can aid in diagnosing CNS neoplasms.Key woRDS: central nervous system, cerebrospinal fluid, malignant cells, CNS neoplasm, CNS tumors. Características citológicas e bioquímicas do líquido cefalorraquidiano na presença de neoplasias no SNCReSUMo -A infiltração neoplásica no SNC deve ser afastada em pacientes com neoplasia e sintomas neurológicos. Foi realizada uma análise retrospectiva de 1.948 amostras de LCR de pacientes com suspeita de infiltração neoplásica no SNC. Sessenta e dois por cento dos pacientes eram portadores de leucemia linfocitica aguda. Células neoplásicas foram encontradas em 24% de todas as amostras. Houve níveis aumentados no LCR da proteína total (PT), glicose e de citologia global (p<0.05), no grupo com presença de cé-lulas neoplásicas. A média da contagem global de células no LCR, neste grupo, foi 232±933 cels/mm 3 , contra 9±93 cells/mm 3 no grupo sem células neoplásicas no LCR (p=0,029). o aumento de PT no LCR apresentou especificidade 87% e valor preditivo negativo (VPN) 96%. A contagem global de células no LCR apresentou especificidade 86% e VPN 97%. Porém sensibilidade e valores preditivos positivos foram baixos. A presença de células inflamatórias e PT no LCR elevada em pacientes com neoplasias pode ser um indicador do envolvimento no SNC. PALAVRAS-CHAVe: sistema nervoso central, líquido cefalorraquidiano, células neoplásicas, neoplasias.

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New and old diagnostic markers of meningitis in cerebrospinal fluid (CSF)

Cited by 69 publications

References 34 publications

Quantitation of cerebrospinal fluid lactic acid in infectious and non-infectious neurological diseases

Quantitation of cerebrospinal fluid lactic acid in infectious and non-infectious neurological diseases

Laboratorial diagnosis of lymphocytic meningitis

Cerebrospinal fluid cytological and biochemical characteristics in the presence of CNS neoplasia

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