The Journal of infection
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The Journal of infection · Apr 2011
Review Meta AnalysisDiagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis.
Cerebrospinal fluid (CSF) lactate is produced by bacterial anaerobic metabolism and is not affected by blood lactate concentration, an advantage over CSF glucose in differentiating bacterial meningitis from aseptic meningitis. However, the previous investigations have shown mixed results of the sensitivity and specificity. Our study's purpose was to assess the utility of CSF lactate in differentiating bacterial meningitis from aseptic meningitis. ⋯ CSF lactate's high negative likelihood ratio may make it useful for ruling out bacterial meningitis though pretreatment with antibiotics reduces clinical accuracy. CSF lactate of 35 mg/dl could be optimal cut-off value for distinguishing bacterial meningitis from aseptic meningitis.