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Cerebrospinal fluid white cell, glucose and protein changes during the treatment of Haemophilus influenzae meningitis

P Valmari, H Peltola, M Kataja

    Scandinavian Journal of Infectious Diseases
    |January 1, 1986
    PubMed

    Insights

    Cerebrospinal fluid (CSF) analysis in children with Haemophilus influenzae meningitis shows white blood cell counts decline slowly, while glucose normalizes quickly. Sequential CSF monitoring offers limited value for recovery after sterilization.

    Area of Science:

    • Pediatric Infectious Diseases
    • Neuroscience
    • Clinical Chemistry

    Background:

    • Haemophilus influenzae meningitis is a serious infection in children.
    • Establishing reference values for cerebrospinal fluid (CSF) parameters during the convalescence period of meningitis is crucial for monitoring recovery.
    • Existing reference values for CSF white blood cell (WBC) count, glucose, and protein are lacking for the recovery phase of H. influenzae meningitis.

    Purpose of the Study:

    • To determine the kinetics of CSF WBC count, glucose, and protein concentrations during the first 10 days of treatment for H. influenzae meningitis in children.
    • To establish percentile distribution graphs for these CSF parameters during the convalescence period.
    • To evaluate the utility of sequential CSF analysis in monitoring recovery from H. influenzae meningitis.

    Main Methods:

    • Analysis of 298 CSF samples from 116 children with H. influenzae meningitis.
    • Sequential monitoring of CSF white blood cell (WBC) count, glucose, and protein concentrations.
    • Presentation of data as percentile distribution graphs for the first 10 days of treatment.

    Main Results:

    • CSF WBC counts initially increased slightly then declined, but remained elevated above normal (<5/microliter) in most cases within 10 days.
    • CSF glucose levels typically normalized or neared normal within 48 hours.
    • CSF protein concentrations showed a steady decline throughout the treatment period.
    • Extremely high WBC or low glucose levels indicated potential neurological complications or treatment failure.

    Conclusions:

    • Sequential CSF WBC, glucose, and protein levels provide limited, vague information for monitoring recovery from H. influenzae meningitis.
    • Routine lumbar punctures after CSF sterilization may not be indicated due to the limited value of sequential monitoring.
    • The kinetics observed provide preliminary reference data for the convalescence period of childhood H. influenzae meningitis.

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