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Cerebrospinal fluid lactate concentration and bacterial encephalitis diagnosis
M Maillet1, T De Broucker2, A Mailles3
1Service de maladies infectieuses, centre hospitalier universitaire de Grenoble, BP 218, 38043 Grenoble cedex 9, France.
Medecine Et Maladies Infectieuses
|June 20, 2018
Summary
Cerebrospinal fluid (CSF) lactate levels effectively predict bacterial encephalitis. Elevated CSF lactate is a superior marker compared to white blood cells or protein for diagnosing bacterial encephalitis.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Infectious encephalitis presents a diagnostic challenge, with bacterial causes requiring prompt identification.
- Distinguishing bacterial encephalitis from other forms is crucial for timely and appropriate treatment.
Purpose of the Study:
- To evaluate the diagnostic value of cerebrospinal fluid (CSF) lactate concentration in identifying bacterial encephalitis.
- To compare the predictive accuracy of CSF lactate against traditional markers like white blood cell (WBC) count and protein levels.
Main Methods:
- Analysis of CSF lactate levels from a cohort of infectious encephalitis patients.
- Utilized univariate and multivariate logistic regression to assess associations with bacterial etiology.
- Employed Receiver Operating Characteristic (ROC) curve analysis to determine the optimal CSF lactate cut-off value.
Main Results:
- CSF lactate concentration was independently associated with bacterial encephalitis in multivariate analysis.
- The area under the ROC curve for CSF lactate was 0.86.
- A CSF lactate cut-off of 3.4 mmol/L achieved 70% sensitivity and 91.5% specificity for bacterial encephalitis diagnosis.
Conclusions:
- CSF lactate concentration is a valuable and independent predictor of bacterial encephalitis.
- Elevated CSF lactate levels offer a more reliable diagnostic indicator than WBC count or protein levels in differentiating bacterial from other causes of encephalitis.
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