Menigitis, despite the development of effective antibiotics, is still a disease of high mortality and morbidity in pediatrics(Light,1967). it is a disease attracting a great deal of attention by pediatricians.
Sometimes meningitis in childhood shows atypical clinical symptoms and signs. The occurence of bacterial meningitis in the neonatal period and infants creates special problems in early diagnosis, vecause the signs of meningeal irritation are often minimal or ninezistent(Weliman,1967).
Examination of the spinal fluid is the only method for immediate confirmation of the diagnosis of meningitis. One of the most characteristic abnomalities of cerebrospinal fluid in patients with bacterial and tuberculous meningitis is a decrease in glucose content(Menkes,1969).
Even though the reading of the cerebrospinal fluid may be abnormal (i.e. below 40mg%) no definite diagnosis can be made by this examination alone. Futhermore in general practice the clinical symptoms and laboratory data are often abscured because of the indiscriminate use or poor administrarion of antibiotics.
Studied were carried out on 58 meningitis patients and 33 normal or non-meningitis patients as control whose age ranged from birth to 15 years old divided into 4 experimental group as follows:
GroupⅠ. normal or non-meningitis patients..............33 cases
GroupⅡ. purulent meningitis patients...................20 cases
GroupⅢ. tuberculous meningitis patients................30 cases
GroupⅣ. aseptic meningitis patients.................... 8 cases
Spinal trapping Somogyi micromethod (Nelson,1944, Somogyi,1945).
The follow results were obtained:
1. Blood glucose concentration in all experimental groups was around 86 mg%.
2. Glucose concentration of cerebrospinal fluid was normal in groupⅣ as compared to 55.73±2.23mg% in groupⅠbut was significantly decreased to 18.28±2.00 and 24.61±2.03mg% in groupⅡ and groupⅢ, respectively.
3. In groupⅠglucose concentration of cerebrospinal fluid and blood was closely related (r=0.755) but in groupⅡ, Ⅲ and Ⅳ the relationship was markedly dissociated.
4. the ratio of glucose concentration of cerebrospinal fluid to that of blood was 0.65±0.01 in groupⅠ, 0.22±0.02 in groupⅡ, 0.28±0.22 in groupⅢ and 0.64±0.02 in groupⅣ.
On the basis of the above results it may be concluded that the glucose concentration of cerebrospinal fluid in meningilis is a good index of diagnosis and the relationship between blood and cerebrospinal fluid glucose concentration can be a helpful index for its diagnosis as well.
|