Revival of old diagnostic markers in the cerebrospinal fluid for the detection of infectious meningitis

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  • Sakushima Ken
    Department of Neurology, Hokkaido University Graduate School of Medicine
  • Yabe Ichiro
    Department of Neurology, Hokkaido University Graduate School of Medicine
  • Sasaki Hidenao
    Department of Neurology, Hokkaido University Graduate School of Medicine

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  • 再注目される感染性髄膜炎の古典的髄液診断マーカー
  • サイチュウモク サレル カンセンセイ ズイマクエン ノ コテンテキズイエキ シンダン マーカー

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Abstract

Bacterial meningitis and tubercular meningitis are still neurological emergencies characterized by severe mortality and morbidity. Recent studies of meta-analysis have shown the usefulness of cerebrospinal fluid (CSF) lactate and CSF adenosine deaminase (ADA) as markers for the detection of bacterial meningitis and tubercular meningitis, respectively. CSF lactate has a high sensitivity and specificity for the diagnosis of bacterial meningitis, but the sensitivity can be reduced by antibiotic pretreatment. CSF-ADA has a moderate sensitivity but a high specificity and is reliable for the diagnosis of tubercular meningitis. These old diagnostic markers can be evaluated in resource-poor settings including small general hospitals and non-specialized hospitals for infectious diseases, and they can contribute to the quick and accurate diagnosis of infectious meningitis.<br>

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