The Significance of the nitroblue-tetrazolium test in cerebrospinal fluid granulocytes in bacterial and abacterial meningitis.

The reaction of cerebrospinal fluid (CSF) granulocytes in the nitroblue-tetrazolium test (NBT test) was evaluated. In a previous study, methodological problems were resolved, and the method developed by Park et al, was modified to suit the special conditions of the CSF. Thirty-eight CSF specimens from 26 patients were analysed. It appears that NBT test results with CSF granulocytes are significantly positive--according to the criteria developed by Park for blood granulocytes--when bacterial meningitis is present. If the cause of the pleocytosis is not bacterial in nature, then the test results are negative in most cases, provided that the CSF sample contains little or no blood. The NBT test in bloody CSF may produce positive results no matter what the cause of the pleocytosis. Our results suggest that the NBT test is a general, non-specific indicator of granulocyte stimulation. It reflects the ability of granulocytes to react to a stress situation of the organism. Bacterial infection results in a conspicuously large number of stimulated (i.e. NBT positive) granulocytes.