Prompt, precise differentiation between various forms of meningitis-aseptic, bacterial and tuberculous-is critical difficult problem for the practicing pediatrician.
The present investigation was carried out to assess the diagnostic usefullness of lactic acid levels in CSF. Fresh samples of CSF and blood were collected from 75 infant and children with meningitis and 25 normal children.
CSF lactic acid, CSF sugar, blood lactic acid and blood sugar were estimated from them. These subjects were divided into 4 groups: Group 1 (normal-25 cases), Group 2 (aseptic meningitis-25 cases), Group 3 (purulent meningitis-20 cases), Group 4 (T.B. meningitis-30 cases).
The results were as follows:
1. In normal group, CSF lactic acid was 5.8mg/dl and blood lactic acid was 7. 1 mg/dl. The ratio of CSF Lactic acid to blood lactic acid was approximately 0.8.
2. In Group 2. (aseptic meningitis), CSF lactic acid was 8.8 mg/di and blood lactic acid was 7. 4mg/dl. The CSF value was slightly increased compare to normal CSF lactic acid levels. CSF sugar and lactic acid were not correlated.
3. In the purulent meningitis group, CSF lactic acid was markedly increased to a significant level compare to the normal value. The mean was 36.4 mg/dl. Blood lactic acid also increased in linear fashion with CSF lactic acid. The mean value of blood lactic acid was 26.2 mg/dl.
4. In T.B. meningitis, There as a mederate increase of lactic acid significantly ifferent from normal values. The mean was 25. 8mg, dl. Blood lactic acid also increased. The mean was 18.9 mg,,´di. A positive linear correlation between CSF lactic acid and blood lactic acid was noted.
5. Can the 3rd hospital day, CSF lactic acid level wsa approximately half level of the initial values inpurulent´meningitis. It returned to normal level on Gth hospital day. In T.B. menin gitis, CSF lactic acid also showeda decrease from the 5th hospital day. and returned to normal values on 20th hospital day.
Concerning the above results, CSF lactic acid could be a possibiely be a good index in differential diagnosis of meningitis and in evaluation or it´s clinical course.
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