Lactate and glucose in cerebrospinal fluid heavily contaminated with blood.

To simulate a traumatic lumbar puncture, blood was added to 33 normal cerebrospinal fluid (CSF) specimens. A hypothesis was tested if the CSF glucose and CSF lactate were unchanged after contamination with blood. Lactate and glucose here measured in both normal and blood-stained CSF. The estimated contamination of the normal CSF with red cells ranged from 84000 to 676500 cells per cubic millimeter. CSF lactate was unchanged by the addition of blood (P = 0.8), whereas CSF glucose was significantly higher in the blood-stained CSF (P = 0.0005). Therefore, the determination of lactate levels in the CSF heavily contaminated with blood could be useful in differentiating viral from bacterial meningitis.