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Aids in Differential Diagnosis

Richard D. Bland, MD; Robert C. Lister, MD; John P. Ries, MD

Am J Dis Child. 1974;128(2):151-156.

Abstract
Analyses of cerebrospinal fluid (CSF) for lactic acid content and pH were performed in infants and children with different types of meningitis and in varying stages of therapy to assess the clinical usefulness of these determinations. There were significant differences in both measurements for patients with aseptic, purulent, and "partially-treated" bacterial meningitis. Those with the incompletely-treated disease had an intermediate elevation in CSF lactic acid and intermediate reduction in pH compared to those with untreated suppurative meningitis and those with the fully-treated disease, or aseptic variety. Moreover, a decreasing lactic acid level in purulent meningitis was indicative of effective therapy and resolution of infection.

Author Affiliations
From the Department of Pediatrics, Tripler Army Medical Center, Honolulu. Dr. Bland is now with the University of California at San Francisco; Dr. Lister with North Carolina University School of Medicine, Chapel Hill; and Dr. Ries at Fort Carson, Colorado Springs, Colo.

Footnotes
Received for publication June 21, 1973; accepted Feb 28, 1974.

Read in part before the Western Society for Pediatric Research, Carmel, Calif, Feb 3, 1972; and before the Uniformed Services Pediatric Seminar, San Francisco, March 14, 1973.

Reprint requests to the Cardiovascular Research Institute, University of California School of Medicine, San Francisco, CA 94143 (Dr. Bland).

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