Cerebrospinal fluid lactic acid levels in meningitis

Area of Science:

• Clinical Microbiology
• Neuroscience
• Biochemistry

Background:

• Early and accurate diagnosis of bacterial meningitis is crucial for effective patient management and outcomes.
• Traditional diagnostic methods can sometimes be slow, necessitating the exploration of rapid and reliable biomarkers.
• Cerebrospinal fluid (CSF) analysis is a cornerstone in diagnosing central nervous system infections.

Purpose of the Study:

• To evaluate the efficacy of measuring cerebrospinal fluid (CSF) lactic acid for the early detection of bacterial meningitis.
• To compare gas-liquid chromatography and enzymatic Monotest lactate assays for CSF lactic acid determination.
• To assess the correlation between CSF lactate levels and clinical response to therapy in meningitis patients.

Main Methods:

• CSF lactic acid was measured using gas-liquid chromatography and an enzymatic Monotest lactate assay.
• The study included 396 patients, analyzing spinal fluid specimens for lactate levels.
• Lactate levels were compared between patients with confirmed bacterial/mycoplasma etiology and those without.

Main Results:

• All 62 patients with bacterial or mycoplasma meningitis showed elevated CSF lactic acid levels above the normal range.
• 334 patients without bacterial involvement had CSF lactate values within the normal range.
• Elevated CSF lactate levels persisted in correlation with the clinical response to antibiotic therapy.

Conclusions:

• CSF lactic acid determination is a rapid and reliable diagnostic tool for early detection of pyogenic meningitis.
• This biomarker effectively identifies both untreated and partially treated bacterial meningitis.
• Measuring CSF lactic acid, alongside clinical evaluation, aids in timely diagnosis and treatment monitoring.