The utility of cerebrospinal fluid parameters in the early microbiological assessment of meningitis

White, Kyle; Ostrowski, Kevin; Maloney, Samuel; Norton, Robert

doi:10.1016/j.diagmicrobio.2012.02.010

Cited by 23 publications

(17 citation statements)

References 34 publications

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“…Meningitis can be pyogenic (pus forming), which is associated with common bacterial etiologies (described below), or aseptic, in which pyogenic bacteria are not isolated from the cerebrospinal fluid (CSF) and the causative agent may be viral or mycobacterial or there is a noninfective etiology. Features of CSF which would generally exclude a bacterial etiology for meningitis include a protein concentration of Ͻ600 mg/liter and a white cell count of Ͻ90 ϫ 10 6 /liter (2). The classic triad of fever, neck stiffness, and a change in mental state is observed in 44% of patients with bacterial meningitis (11).…”

Section: Meningitismentioning

confidence: 99%

“…CNS infections are frequently caused by viruses, such as the enteroviruses, which cause the majority of cases of aseptic meningitis and meningoencephalitis (1)(2)(3). Other neurotropic viruses, such as human cytomegalovirus, herpes simplex viruses, varicella-zoster virus, and the emerging viruses West Nile virus, henipaviruses, Japanese encephalitis virus, chikungunya virus, Ebola virus, and rabies virus, may also cause CNS infections (4-7).…”

mentioning

confidence: 99%

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Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

et al. 2014

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SUMMARY The brain is well protected against microbial invasion by cellular barriers, such as the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (BCSFB). In addition, cells within the central nervous system (CNS) are capable of producing an immune response against invading pathogens. Nonetheless, a range of pathogenic microbes make their way to the CNS, and the resulting infections can cause significant morbidity and mortality. Bacteria, amoebae, fungi, and viruses are capable of CNS invasion, with the latter using axonal transport as a common route of infection. In this review, we compare the mechanisms by which bacterial pathogens reach the CNS and infect the brain. In particular, we focus on recent data regarding mechanisms of bacterial translocation from the nasal mucosa to the brain, which represents a little explored pathway of bacterial invasion but has been proposed as being particularly important in explaining how infection with Burkholderia pseudomallei can result in melioidosis encephalomyelitis.

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Section: Meningitismentioning

confidence: 99%

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confidence: 99%

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

et al. 2014

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“…The analysis of some of the CSF laboratory parameters (PCR, leukocytes, erythrocytes, glucose, and proteins) is often the first clue to the diagnosis 16,18 .…”

Section: Discussionmentioning

confidence: 99%

Laboratory Parameters of Cerebrospinal Fluid in Individuals With Enterovirus Meningitis: A Descriptive Study

Alves

Wajnsztejn

Alves

et al. 2015

J. Hum. Growth Dev.

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Abstract:Introduction: Meningitis is the leading infectious syndrome that affects the central nervous system, and most cases are caused by viral infections, mainly enterovirus. The clinical diagnosis for meningitis etiology still presents major challenges. The analysis of polymerase chain reaction (PCR), white blood cells, red blood cells, glucose, protein, and lactate in the cerebrospinal fluid (CSF) provides the first clues to the diagnosis. However, the reference values of some parameters can suffer changes. Objective: Analyze the laboratory parameters of CSF in patients with enterovirus meningitis, and then, theirrelationship by age group. Methods: A descriptive study was conducted based on data from a CSF reference service, located in São Paulo, Brazil, on 202 individuals who had enterovirus meningitis. Data was analysed by the Shapiro-Wilk and Kruskal-Wallis tests (CI = 95%, p < 0.05) and represented by the median and percentile 25 and 75, respectively. Results: The cytological and biochemical parameters of the CSF shows us that proteins had median concentrations of 33.0mg/ dL, glucose of 57.0mg/dl, lactate of 19.0mg/dL and the leukocyte of 119.0 cells/mm 3 , with a predominance of lymphocytes (42%). It was found that age can cause cytological and biochemical changes in the parameters of CSF. Children younger than 2 years had a range percentage of neutrophils and monocytes different then children aged < 2 and < 6 years, and aged < 6 and < 10 years. The protein concentration range in CSF as well as glucose track can also change according to age. Conclusion:The parameters of the CSF in patients with enteroviral meningitis showed similar median concentrations to those found in the literature. Age may lead to changes in cytological and biochemical parameters of CSF. CSF protein and glucose concentrations also change according to age.

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“…CSF protein and white cell count may be the most useful tests in differentiating between viral, bacterial and cryptococcal meningitis, while CSF glucose concentration is less useful. 29 A low glucose indicates a metabolically active process, but glucose can be low in both infective and neoplastic meningitis. It would also be important to know the results of cryptococcal antigen and tuberculosis (TB) PCR on CSF and cryptococcal serology on blood.…”

Section: Infective and Neoplastic Causesmentioning

confidence: 99%

Rapidly progressive dementia and ataxia in an elderly man

Hálmagyi

Rodriguez

2013

Pract Neurol

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The utility of cerebrospinal fluid parameters in the early microbiological assessment of meningitis

Cited by 23 publications

References 34 publications

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

Laboratory Parameters of Cerebrospinal Fluid in Individuals With Enterovirus Meningitis: A Descriptive Study

Rapidly progressive dementia and ataxia in an elderly man

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