Differential Diagnosis Of Acute Meningitis In Adults

Objective To analyze the quantitive standards and sensitivity of multiple laboratory marker in the differential diagnosis of bacterial or viral meningitis and try to discuss its clinical value. Method 57 patients with acute bacterial and viral meningitis were retrospectively analyzed. Clinical symptoms and peripheral blood picture as well as laboratory findings of cerebrospianl fluid(CSF) were compared respectively. Result Acute bacterical meningitis was hardly differentiated from acute viral one by clinical symptoms and peripheral blood picture. But acute bacterical meningitis should be highly suspected in patients with a CSF glucose level less than 1.7mmol/L, a CSF-blood glucose ratio less than 0.35, a CSF protein level greater than 2.0g/L, more than 2000.0×l0~6/L CSF leukocytes, or more than 1000.0×l0~6/L CSF polymorphonuclear leukocytes. The sensitivity of the subsequence of the laboratory markers were as follows: CSF-blood glucose ratio, CSF glucose level, CSF protein level and CSF polymorphonuclear leukocytes, CSF leukocytes. Conclusion the quantitive standard and main differential points of multiple laboratory marker help to increase the diagnostic accuracy of acute bacterical meningitis and decrease the rate of misdiagnosis.