Cerebrospinal fluid prognostic indices in experimental pneumococcal meningitis.
The prognostic value of initial and sequential determinations of quantitative bacterial concentrations, leukocytes, glucose, lactate, lactic acid dehydrogenase, and creatine phosphokinase in CSF was examined in rabbits with experimental pneumococcal meningitis while they were receiving equivalent, rapidly bactericidal antibiotic therapy. The following mean CSF variables correlated with death due to meningitis: (1) an early (day 1) high bacterial titer and lactate concentration with simultaneous low leukocyte count and glucose level and (2) late (day 3) elevated lactate and lactic acid dehydrogenase levels and leukocyte count. A high concentration of bacteria inoculated into the CSF and a high plasma glucose level also adversely influenced prognosis. Careful analysis of these variables may identify high-risk patients with pneumococcal meningitis and ultimately may be useful in gauging the therapeutic response.
D000818:Animals; D003402:Creatine Kinase / Q000134:cerebrospinal fluid; D005947:Glucose / Q000134:cerebrospinal fluid; D007770:L-Lactate Dehydrogenase / Q000134:cerebrospinal fluid; D007773:Lactates / Q000134:cerebrospinal fluid; D019344:Lactic Acid; D007958:Leukocyte Count; D008586:Meningitis, Pneumococcal / Q000097:blood / Q000134:cerebrospinal fluid* / Q000382:microbiology; D011379:Prognosis; D011817:Rabbits
D007773:Lactates; D019344:Lactic Acid; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase; D005947:Glucose