International Medical Journal, Vol. 21., Iss. 3, 2015, P. 70−74.
BIOCHEMICAL INDICATORS OF CEREBROSPINAL FLUID IN PATIENTS WITH ACUTE MENINGOCOCCAL END ENTEROVIRAL MENINGITIS
Kharkiv National Medical University, Ukraine
Regional Clinical Hospital of Infectious Diseases, Kharkiv, Ukraine
The studies aimed at determining the criteria of early prognosis of meningitis course for early correction of complex treatment and improvement of its efficiency are relevant at the moment. The purpose of our study was to investigate the clinical and laboratory features of acute meningitis and assess the values of some parameters of cerebrospinal fluid (CSF) in early diagnosis and prognosis of the disease. We analyzed the data from 313 HIV−negative patients with acute meningitis from Kharkiv region for the period 2011−2013. Among them 229 (73.2 %) patients had serous meningitis and 84 (26.8 %) purulent meningitis. The first group included 29 patients with meningococcal meningitis. The second group included 14 patients with acute enteroviral meningitis. The etiology of the disease was confirmed by PCR and bacteriological studies of cerebrospinal fluid. In the first and second groups of patients we determined the levels of cortisol, creatine kinase, lactate, lactate dehydrogenase, total cholinesterase CSF on admission and after 10−12 days of treatment. Analysis of clinical data of CSF investigation showed that the level of cell count was inversely dependent on the severity of the disease (p < 0.0001). Total blood count during the acute phase of the disease showed that only the level of white blood cells was significantly higher in the group with severe disease (p < 0.0001). In patients of the second group lactate and lactate dehydrogenase levels were significantly lower (p < 0.0001) than in the first group. Total creatine kinase levels were significantly (p < 0.0001) higher in the CSF of patients of the first group. Indicators of cholinesterase in the CSF during the acute phase of meningococcal meningitis were inversely related to the severity of the disease (p < 0.0001). Our findings suggest the importance of determining cortisol, lactate, cholinesterase in the CSF to determine the severity of the patient's condition and prognosis of the disease.
Key words: meningococcal end enteroviral meningitis, biochemical parameters of cerebrospinal fluid, early diagnosis.