Abstract

CEREBROSPINAL FLUID LACTATE IN MENINGITIS IN CHILDREN

Author(s): Bindu Krishnan Padma1, Deepa Kunju Krishnan2

BACKGROUND
Meningitis is an inflammation of meninges and subarachnoid space and is often associated with cerebritis. Acute bacterial meningitis is one of the most common serious infections in children. Viral meningitis has a much more favourable prognosis. Cerebrospinal fluid analysis has got an important role in the diagnosis of neurological disorders. CSF lactate can be elevated in disorders like subarachnoid haemorrhage, bacterial meningitis, status epilepticus and inborn errors of metabolism.
The aim of the present study is to evaluate the level of CSF lactate in bacterial and viral meningitis, its role in the assessment of early prognosis of bacterial meningitis and its relationship with CSF parameters like cellularity, glucose and protein in bacterial meningitis.
MATERIALS AND METHODS
This is a descriptive study conducted in a tertiary care hospital. In this study, 65 cases of meningitis admitted in the hospital under the Department of Paediatrics were included. Cases were grouped as bacterial meningitis and viral meningitis after clinical assessment and CSF analysis. CSF lactate estimation was done by the dry chemistry method. Using statistical methods, CSF lactate level was compared between viral and bacterial meningitis group and CSF lactate level was analysed for its association with the development of acute complications and its relationship with other routinely measured CSF parameters were analysed.
RESULTS
The level of CSF lactate in bacterial meningitis was higher than that in viral meningitis with statistical significance of p <0.01. The mean CSF lactate value in bacterial and viral meningitis was 7.62 ± 2.07 mmol/L and 2.08 ± 0.35 mmol/L, respectively. The mean value of CSF lactate in patients who developed complication was 9.49 ± 1.65 mmol/L, whereas it was significantly lower in those without complication 6.38 ± 1.2 mmol/L, p <0.01. The level of CSF lactate presented negative correlation with CSF glucose and positive correlation with CSF protein in bacterial meningitis, whereas no significant relation was found between CSF lactate and CSF cellularity.
CONCLUSION
Lactate level in CSF is significantly elevated in bacterial than that in viral meningitis. High CSF lactate level was associated with the development of acute complications and it showed a positive correlation with CSF protein and negative correlation with CSF glucose in bacterial meningitis.

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