Rinsho Shinkeigaku (Clinical Neurology)


Revival of old diagnostic markers in the cerebrospinal fluid for the detection of infectious meningitis

Ken Sakushima, M.D., M.P.H., Ichiro Yabe, M.D., Ph.D. and Hidenao Sasaki, M.D., Ph.D.

Department of Neurology, Hokkaido University Graduate School of Medicine

Bacterial meningitis and tubercular meningitis are still neurological emergencies characterized by severe mortality and morbidity. Recent studies of meta-analysis have shown the usefulness of cerebrospinal fluid (CSF) lactate and CSF adenosine deaminase (ADA) as markers for the detection of bacterial meningitis and tubercular meningitis, respectively. CSF lactate has a high sensitivity and specificity for the diagnosis of bacterial meningitis, but the sensitivity can be reduced by antibiotic pretreatment. CSF-ADA has a moderate sensitivity but a high specificity and is reliable for the diagnosis of tubercular meningitis. These old diagnostic markers can be evaluated in resource-poor settings including small general hospitals and non-specialized hospitals for infectious diseases, and they can contribute to the quick and accurate diagnosis of infectious meningitis.
Full Text of this Article in Japanese PDF (278K)

(CLINICA NEUROL, 52: 6|11, 2012)
key words: bacterial meningitis, tubercular meningitis, cerebrospinal fluid, lactate, adenosine deaminase

(Received: 1-Jun-11)