CSF markers for diagnosis of bacterial meningitis in neurosurgical postoperative patients

Objective: To evaluate the diagnostic usefulness of cerebral spinal fluid (CSF) cellularity, protein, neutrophils, glucose and lactate for detection of postoperative bacterial meningitis. Method: This prospective study was conducted in 28 postoperative neurosurgical patients from 2002 to 2005 at University of Sao Paulo. The CSF markers were plotted in a receiver operating characteristic (ROC) curve to evaluate their accuracy. Results: Based on the area under ROC curve CSF glucose, cellularity, and lactate were considered good tests. Polymorphonuclear and protein did not achieve enough accuracy to be used clinically. Conclusion: The CSF glucose, lactate, and cellularity can be used for the diagnosis of bacterial meningitis. Moreover, it can be helpful to differentiate bacterial from aseptic meningitis.