Cerebrospinal fluid investigations in tuberculous meningitis

Ann Trop Paediatr. 1991;11(3):241-6. doi: 10.1080/02724936.1991.11747509.

Abstract

The results of conventional cerebrospinal fluid (CSF) investigations (CSF cell count, protein and glucose concentrations and Pandy's test for CSF globulin) obtained on admission and sequentially from weekly follow-up lumbar punctures for 4 weeks were evaluated in 99 children (median age 28 months) with stage II (50 children) and stage III (49 children) tuberculous meningitis. On admission, six children (6%) had a CSF cell count greater than 500 x 10(6)/l and nine (9%) a polymorphonuclear predominance. A CSF protein less than 0.8 g/l was found in 17 children (18%) of 97 in whom CSF protein was evaluated. Globulin was either absent or present as a trace only in 26 children (27%). CSF glucose was less than 2.2 mmol/l in 58 cases (60%) and less than 2.5 mmol/l in 67 (69%). In 63 children weekly CSF specimens obtained for the 1st 4 weeks of therapy showed an uninterrupted decline in cell count in 23 (37%), a fluctuating downward trend in 27 (43%) and a fluctuating upward trend in 13 (21%). Sequential CSF protein values in 57 children showed an uninterrupted rise in three (5%), a fluctuating upward course in 19 (33%), an uninterrupted downward trend in seven (12%), and a fluctuating downward course in 28 (49%). Of the 61 children in whom sequential CSF glucose concentrations were available, 11 (18%) experienced fluctuating concentrations, values falling to less than 2.2 mmol/l after being greater than 2.2 mmol/l on admission or after having risen to greater than 2.2 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

MeSH terms

  • Adolescent
  • Antitubercular Agents / therapeutic use
  • Cell Count / drug effects
  • Cerebrospinal Fluid Proteins / analysis
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Globulins / cerebrospinal fluid
  • Glucose / cerebrospinal fluid
  • Humans
  • Infant
  • Tuberculosis, Meningeal / cerebrospinal fluid*
  • Tuberculosis, Meningeal / drug therapy

Substances

  • Antitubercular Agents
  • Cerebrospinal Fluid Proteins
  • Globulins
  • Glucose