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Meningitis is a serious clinical problem in many regions of the world especially in the developing countries. Early diagnosis and appropriate treatment of the type of meningitis is crucial to reduce associated mortality and morbidity. The role of CSF lactate in the differential diagnosis between pyogenic from nonpyogenic meningitis has been debatable for long. We investigated the diagnostic value of CSF lactate in meningitis patients for discriminating between pyogenic and nonpyogenic meningitis in our institute for two years. Materials and Methods: A cross-sectional study was done in 40 cases of suspected meningitis of varied etiologies from October 2011 to October 2013. CSF samples were taken immediately on admission. Based on CSF cytology and biochemical parameters and other specific assays, patients were divided into pyogenic, tubercular and aseptic/viral meningitis. CSF lactate was estimated by the ISE (Ion-selective electrode) method. Results: Of the 40 patients with meningitis, 16 were pyogenic and 24 nonpyogenic (9 tubercular and 15 aseptic/viral). Mean CSF lactate levels was 11.66 mmol /L, 4.0 mmol /L and 1.99 mmol /L in pyogenic meningitis, tubercular meningitis and viral meningitis respectively (P<0.001). Mean CSF lactate was significantly high in pyogenic meningitis and tubercular meningitis compared to viral meningitis. Using a higher cut off value of 5 mmol/L, CSF lactate helped in differentiating pyogenic from tubercular meningitis (P<0.001). Conclusion: CSF lactate can provide legitimate, quick and explicit diagnostic information in differentiating pyogenic from nonpyogenic meningitis (tubercular and viral). © 2019 Published by Innovative Publication.

Estimation of CSF lactate as a diagnostic marker to differentiate pyogenic meningitis from nonpyogenic meningitis