CSF lactate for accurate diagnosis of community-acquired bacterial meningitis

CSF lactate measurement is recommended when nosocomial meningitis is suspected, but its value in community-acquired bacterial meningitis is controversial. We evaluated the diagnostic performance of lactate and other CSF parameters in a prospective cohort of adult patients with acute meningitis. Diag...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2015-10, Vol.34 (10), p.2049-2055
Main Authors: Giulieri, S., Chapuis-Taillard, C., Jaton, K., Cometta, A., Chuard, C., Hugli, O., Du Pasquier, R., Bille, J., Meylan, P., Manuel, O., Marchetti, O.
Format: Article
Language:English
Subjects:
Accuracy
Adolescent
Adult
Aged
Aged, 80 and over
Antibiotics
Bacteria
Biomedical and Life Sciences
Biomedicine
Cohort Studies
Cross Infection - diagnosis
Documentation
Emergency medical care
Enterovirus
Etiology
Female
Humans
Infectious diseases
Internal Medicine
Laboratories
Lactic Acid - blood
Male
Medical Microbiology
Medicine
Meningitis
Meningitis, Bacterial - blood
Meningitis, Bacterial - diagnosis
Meningitis, Viral - blood
Meningitis, Viral - diagnosis
Middle Aged
Mortality
Nosocomial infection
Nuclear polyhedrosis virus
Prospective Studies
Receptors, Colony-Stimulating Factor - blood
Sensitivity and Specificity
Steroids
Streptococcus infections
Streptococcus pneumoniae
Switzerland
Varicella-zoster virus
Young Adult
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Description
Summary:CSF lactate measurement is recommended when nosocomial meningitis is suspected, but its value in community-acquired bacterial meningitis is controversial. We evaluated the diagnostic performance of lactate and other CSF parameters in a prospective cohort of adult patients with acute meningitis. Diagnostic accuracy of lactate and other CSF parameters in patients with microbiologically documented episodes was assessed by receiver operating characteristic (ROC) curves. The cut-offs with the best diagnostic performance were determined. Forty-five of 61 patients (74 %) had a documented bacterial ( n  = 18; S. pneumoniae, 11; N. meningitidis, 5; other, 2) or viral ( n  = 27 enterovirus, 21; VZV, 3; other, 3) etiology. CSF parameters were significantly different in bacterial vs. viral meningitis, respectively ( p  
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-015-2450-6