Cerebrospinal fluid/blood glucose ratio as an indicator for bacterial meningitis

The American Journal of Emergency Medicine
Hidetaka TamuneMitsuhiro Nakamura

Abstract

Bacterial meningitis is an emergent disease requiring prompt diagnosis and treatment with appropriate antimicrobials. Although the lumbar puncture is widely used as a diagnostic tool for bacterial meningitis, it remains unclear which value in cerebrospinal fluid (CSF) analysis in emergency laboratory tests precisely predicts the presence of bacterial meningitis. This is a single-center, retrospective review of medical records to determine which emergency laboratory CSF test results are useful for predicting bacterial meningitis. The diagnosis of meningitis is made when the white blood cell count in CSF exceeds 5 cells/μL, while the diagnosis of bacterial meningitis additionally requires the growth of a pathogen from a CSF culture or the identification of a pathogen in Gram staining of CSF specimen. We identified 15 patients with bacterial meningitis and 129 patients with aseptic meningitis. While neutrophil-predominant pleocytosis and a decreased glucose level in CSF can predict the presence of bacterial meningitis, the CSF/blood glucose ratio is more precise (optimal cut-off=0.36, sensitivity=92.9%, specificity=92.9%, area under the curve=.97) even after administration of antimicrobials prior to examination in the emergency de...Continue Reading

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Citations

Feb 29, 2016·The American Journal of Emergency Medicine·Hidetaka Tamune, Takaie Kuki
Feb 25, 2014·The American Journal of Emergency Medicine·Hidetaka Tamune, Takaie Kuki
Apr 14, 2016·Clinical Rheumatology·Mohamed OmarPhilipp Mommsen
Nov 1, 2015·The American Journal of Emergency Medicine·Ryota SatoYusuke Kitahara
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Sep 30, 2016·Seminars in Immunology·Jessica WallsDavid Finlay
Jan 20, 2015·Korean journal of anesthesiology·Soon-Kul Kwon, Mi-Woon Kim
Sep 5, 2018·Headache·Hidetaka TamuneToshiki Uchihara
Aug 12, 2017·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Geoffroy RousseauAntoine Guillon
Dec 12, 2018·The Journal of Antimicrobial Chemotherapy·Alexia ChauzyPascal Chavanet
Feb 26, 2019·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Hidetaka Tamune, Takaie Kuki
Nov 19, 2014·Clinical Chemistry and Laboratory Medicine : CCLM·Milan DastychZdenka Cermáková
May 11, 2019·Nature Communications·Nidhi Kedia-Mehta, David K Finlay
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May 18, 2019·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Rebai LotfiBadri Mohamed

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