ArticleRevista do Instituto de Medicina Tropical de Sao Paulo2019
Performance of lactate in discriminating bacterial meningitis from enteroviral meningitis.
Article in Revista do Instituto de Medicina Tropical de Sao Paulo, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Management of Acute Bacterial Meningitis in Children.Infection and drug resistance · 2020Review
- Sample Size Calculation Guide - Part 4: How to Calculate the Sample Size for a Diagnostic Test Accuracy Study based on Sensitivity, Specificity, and the Area Under the ROC Curve.Advanced journal of emergency medicine · 2019Article
- FilmArray Meningitis/Encephalitis (ME) panel in the diagnosis of bacterial meningitis.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
- Diagnostic accuracy of cerebrospinal fluid lactate in confirmed cases of acute bacterial meningitis in children.Pakistan journal of medical sciencesArticle
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Authors and funding
4 authors.
Funding
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Abstract
The cytological and biochemical examination of cerebrospinal fluid (CSF) has been used for the presumed diagnosis of bacterial meningitis until the final microbiological results are achieved. We assessed the ability of CSF lactate in comparison with other CSF parameters to discriminate bacterial and enteroviral community acquired meningitis. We included 1,187 CSF samples of acute community-acquired meningitis, being 662 cases of bacterial and 525 of enteroviral meningitis. Lactate concentration (mg/dL), leukocyte count/mm3, protein (mg/dL), and glucose (mg/dL) were compared between bacterial and viral meningitis. Receiver operator characteristic (ROC) curves were used to assess diagnostic performance. CSF leukocytes, CSF protein and CSF lactate were significantly higher in bacterial meningitis cases (P<0.0001). CSF glucose was significantly lower in bacterial meningitis cases (P<0.0001). CSF lactate showed the best predictive ability with an area under the curve of 0.944 (95% CI 0.929 - 0.959). Considering a cut off of CSF lactate of 30 mg/dL, the sensitivity and specificity for bacterial meningitis were 84.1% and 99%, respectively. In the cytological and biochemical CSF analysis, CSF lactate was the most accurate marker for bacterial meningitis.
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