Chemical analyses for early differential diagnosis between bacterial and viral meningitis.

The present study was undertaken to evaluate the benefit of measuring different chemical parameters in the cerebrospinal fluid (CSF), at the time of admittance to hospital, for rapid differentiation between bacterial and viral meningitis. In addition to the leucocyte count, the CSF concentration of total protein, glucose (together with blood glucose), lactate, lactate dehydrogenase and creatine kinase was determined. The results revealed that the CSF lactate and the CSF:blood glucose ratio were the two best parameters for this purpose. When the information from these analyses was combined a complete separation between the two kinds of meningitis could be obtained.