[Importance of cerebrospinal fluid control tests in bacterial meningitis cases as a discharge criterion].
There is controversy regarding indications for cerebrospinal fluid control tests on patients who have clinically recovered from bacterial meningitis, as a cure criterion. Some authors advocate discharge after confirmation of clinical and cerebrospinal fluid normalization, while others maintain that cerebrospinal fluid analysis is not justified in all cases. This case series with group comparisons investigated changes seen in cerebrospinal fluid control tests and evaluated the importance of this for the discharge decision. Out of 297 patients studied, the cerebrospinal fluid control test did not change the discharge intention in 89.9% of the cases (healed cerebrospinal fluid), while in 10.1%, the discharge was suspended (non-healed cerebrospinal fluid). Of these, the antibiotic scheme was changed in 30%. Among the variables that might predict the presence of non-healed cerebrospinal fluid on admission, cerebrospinal fluid protein levels higher than 100mg/dl (p = 0.04) and glycorrhachia lower than or equal to 20 mg/dl (p = 0.03) were associated with a 2.5-times greater chance. These may be useful as criteria for indicating cerebrospinal fluid control tests before discharge.
Cabral
Diogo Buarque Cordeiro
DB
Departamento de Medicina Clínica, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE. diogo.buarque@terra.com.br
Bezerra
Phelipe Cunha
PC
Miranda Filho
Demócrito de Barros
Dde B
Mendizabal
Maria de Fátima Magalhães Acioly
Mde F
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D008875:Middle Aged; D010351:Patient Discharge; D011237:Predictive Value of Tests; D012016:Reference Values