title: Cerebrospinal fluid investigations in tuberculous meningitis.
abstract: The results of conventional cerebrospinal fluid (CSF) investigations (CSF cell count, protein and glucose concentrations and Pandy's test for CSF globulin) obtained on admission and sequentially from weekly follow-up lumbar punctures for 4 weeks were evaluated in 99 children (median age 28 months) with stage II (50 children) and stage III (49 children) tuberculous meningitis. On admission, six children (6%) had a CSF cell count greater than 500 x 10(6)/l and nine (9%) a polymorphonuclear predominance. A CSF protein less than 0.8 g/l was found in 17 children (18%) of 97 in whom CSF protein was evaluated. Globulin was either absent or present as a trace only in 26 children (27%). CSF glucose was less than 2.2 mmol/l in 58 cases (60%) and less than 2.5 mmol/l in 67 (69%). In 63 children weekly CSF specimens obtained for the 1st 4 weeks of therapy showed an uninterrupted decline in cell count in 23 (37%), a fluctuating downward trend in 27 (43%) and a fluctuating upward trend in 13 (21%). Sequential CSF protein values in 57 children showed an uninterrupted rise in three (5%), a fluctuating upward course in 19 (33%), an uninterrupted downward trend in seven (12%), and a fluctuating downward course in 28 (49%). Of the 61 children in whom sequential CSF glucose concentrations were available, 11 (18%) experienced fluctuating concentrations, values falling to less than 2.2 mmol/l after being greater than 2.2 mmol/l on admission or after having risen to greater than 2.2 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Paediatrics & Child Health, Tygerberg Hospital, South Africa.
authors.forename: P R
authors.initials: PR
authors.lastname: Donald
authors.forename: J F
authors.initials: JF
authors.lastname: Schoeman
authors.forename: M F
authors.initials: MF
authors.lastname: Cotton
authors.forename: L E
authors.initials: LE
authors.lastname: van Zyl
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D002452:Cell Count / Q000187:drug effects; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D005916:Globulins / Q000134:cerebrospinal fluid; D005947:Glucose / Q000134:cerebrospinal fluid; D006801:Humans; D007223:Infant; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents; D002556:Cerebrospinal Fluid Proteins; D005916:Globulins; D005947:Glucose