Loading...
Differentiating between bacterial and viral meningitis can be difficult, even if lumbar puncture results are available. To help assess the predictive value of various pieces of clinical data in such cases, these investigators analyzed the records of 422 patients who were admitted with meningitis to Duke University Medical Center from 1969 to 1980.
Bacterial meningitis was ultimately diagnosed in 217 of the patients. Test results that were strongly predictive of bacterial infection included cerebrospinal fluid (CSF) glucose less than 1.9 mmol/L; CSF-blood glucose ratio less than 0.23; CSF protein level greater than 2.2 g/L; or high CSF polymorphonuclear leukocyte (PMN) counts. However, none of these tests could exclude bacterial infection wit…