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Cerebrospinal fluid lactate as a marker to differentiate between community-acquired acute bacterial meningitis and aseptic meningitis/encephalitis in adults: a Danish prospective observational cohort study

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Buch, Kristian ; Bodilsen, Jacob ; Knudsen, Andreas ; Larsen, Lykke ; Helweg-Larsen, Jannik ; Storgaard, Merete ; Brandt, Christian ; Wiese, Lothar ; Østergaard, Christian ; Nielsen, Henrik ; Lebech, Anne-Mette ; Danish Study Group for Infections in the Brain. / Cerebrospinal fluid lactate as a marker to differentiate between community-acquired acute bacterial meningitis and aseptic meningitis/encephalitis in adults : a Danish prospective observational cohort study. I: Infectious diseases (London, England). 2018 ; Bind 50, Nr. 7. s. 514-521.

Bibtex

@article{f5b66a3b832d4ee8bc66aee777bfb34f,
title = "Cerebrospinal fluid lactate as a marker to differentiate between community-acquired acute bacterial meningitis and aseptic meningitis/encephalitis in adults: a Danish prospective observational cohort study",
abstract = "BACKGROUND: The ability of cerebrospinal fluid (CSF) lactate to distinguish between acute bacterial meningitis (ABM) and aseptic meningitis/encephalitis (AME) is debated. We assessed the diagnostic value of CSF lactate to discriminate between ABM and AME.METHODS: We included 176 patients from a prospective adult cohort with neuroinfections. In total, 51 ABM and 125 AME patients with clinically and/or microbiologically diagnosed acute meningitis were examined with CSF-lactate and traditional markers for infection. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance.RESULTS: In CSF, lactate, leukocytes, fraction of neutrophils, protein and glucose ratio, were significantly different between the ABM and AME groups. CSF lactate had the best diagnostic value, with an area under the curve (AUC) of 0.976 (95{\%}CI 0.966-0.997) and using a cut-off of 3.5 mmol/L a sensitivity of 96{\%} and specificity of 85{\%}. Antibiotic treatment before lumbar puncture had no significant effect on the AUC of CSF lactate.CONCLUSIONS: Compared to traditional CSF-markers, CSF lactate is more accurate to distinguish between ABM and AME.",
keywords = "Journal Article",
author = "Kristian Buch and Jacob Bodilsen and Andreas Knudsen and Lykke Larsen and Jannik Helweg-Larsen and Merete Storgaard and Christian Brandt and Lothar Wiese and Christian {\O}stergaard and Henrik Nielsen and Anne-Mette Lebech and {Danish Study Group for Infections in the Brain}",
year = "2018",
doi = "10.1080/23744235.2018.1441539",
language = "English",
volume = "50",
pages = "514--521",
journal = "Infectious Diseases",
issn = "2374-4235",
publisher = "Taylor and Francis Ltd.",
number = "7",

}

RIS

TY - JOUR

T1 - Cerebrospinal fluid lactate as a marker to differentiate between community-acquired acute bacterial meningitis and aseptic meningitis/encephalitis in adults

T2 - a Danish prospective observational cohort study

AU - Buch, Kristian

AU - Bodilsen, Jacob

AU - Knudsen, Andreas

AU - Larsen, Lykke

AU - Helweg-Larsen, Jannik

AU - Storgaard, Merete

AU - Brandt, Christian

AU - Wiese, Lothar

AU - Østergaard, Christian

AU - Nielsen, Henrik

AU - Lebech, Anne-Mette

AU - Danish Study Group for Infections in the Brain

PY - 2018

Y1 - 2018

N2 - BACKGROUND: The ability of cerebrospinal fluid (CSF) lactate to distinguish between acute bacterial meningitis (ABM) and aseptic meningitis/encephalitis (AME) is debated. We assessed the diagnostic value of CSF lactate to discriminate between ABM and AME.METHODS: We included 176 patients from a prospective adult cohort with neuroinfections. In total, 51 ABM and 125 AME patients with clinically and/or microbiologically diagnosed acute meningitis were examined with CSF-lactate and traditional markers for infection. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance.RESULTS: In CSF, lactate, leukocytes, fraction of neutrophils, protein and glucose ratio, were significantly different between the ABM and AME groups. CSF lactate had the best diagnostic value, with an area under the curve (AUC) of 0.976 (95%CI 0.966-0.997) and using a cut-off of 3.5 mmol/L a sensitivity of 96% and specificity of 85%. Antibiotic treatment before lumbar puncture had no significant effect on the AUC of CSF lactate.CONCLUSIONS: Compared to traditional CSF-markers, CSF lactate is more accurate to distinguish between ABM and AME.

AB - BACKGROUND: The ability of cerebrospinal fluid (CSF) lactate to distinguish between acute bacterial meningitis (ABM) and aseptic meningitis/encephalitis (AME) is debated. We assessed the diagnostic value of CSF lactate to discriminate between ABM and AME.METHODS: We included 176 patients from a prospective adult cohort with neuroinfections. In total, 51 ABM and 125 AME patients with clinically and/or microbiologically diagnosed acute meningitis were examined with CSF-lactate and traditional markers for infection. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance.RESULTS: In CSF, lactate, leukocytes, fraction of neutrophils, protein and glucose ratio, were significantly different between the ABM and AME groups. CSF lactate had the best diagnostic value, with an area under the curve (AUC) of 0.976 (95%CI 0.966-0.997) and using a cut-off of 3.5 mmol/L a sensitivity of 96% and specificity of 85%. Antibiotic treatment before lumbar puncture had no significant effect on the AUC of CSF lactate.CONCLUSIONS: Compared to traditional CSF-markers, CSF lactate is more accurate to distinguish between ABM and AME.

KW - Journal Article

U2 - 10.1080/23744235.2018.1441539

DO - 10.1080/23744235.2018.1441539

M3 - Journal article

VL - 50

SP - 514

EP - 521

JO - Infectious Diseases

JF - Infectious Diseases

SN - 2374-4235

IS - 7

ER -

ID: 53547229