Print version ISSN 0004-282X
Arq. Neuro-Psiquiatr. vol.59 no.2A São Paulo June 2001
CRITICAL EVALUATION OF THE DOSAGE OF LACTATE IN THE CEREBROSPINAL FLUID IN INFECTIOUS DISEASES OF THE CENTRAL NERVOUS SYSTEM. (ABSTRACT)*. DISSERTATION. SÃO PAULO, 2001.
HIDERALDO LUÍS SOUZA CABEÇA**
This paper tries to critically analyze the diagnosis aid of the dosage of lactate in the cerebrospinal fluid (CSF) in infectious diseases of the central nervous system (CNS).
We analyzed in a prospective way 130 samples of CSF of 116 patients with diagnoses of infectious processes in the CNS. The 130 samples of CSF were divided into five groups: 28 samples of the control group, 40 of bacterial meningitis, 22 of viral meningitis, 16 of fungal meningitis and 24 of patients presenting Acquired Immune Deficiency Syndrome (AIDS). All samples were submitted to a global score of their number of cells; cytomorphologic test; basic biochemical test; dosage of lactic acid; general immunologic tests; microbiologic and mycologic tests as necessary; immunologic specific tests as indicated.
We determined average, standard deviation, median, minimal and maximum rates of each group for cellularity, total protein contents, glucose and lactate in the samples of CSF.
The concentration of lactate in the CSF was elevated in the group of patients with bacterial meningitis (average = 46,20 mg/dL), fungal meningitis (average = 27, 37 mg/dL) and in the AIDS group (average = 23,54 mg/dL). In the control group and viral meningitis group the lactate content in the CSF presented the reference rates according to the employed method. The groups analyzed were submitted to a paired study in order to avail the statistical significance of the variables as cellularity, total proteins, glucose and lactate in the CSF. The lactate dosage in the CSF presented a negative correlation with glycorrhachia and positive correlation with the cellularity and total proteins of the CSF.
We conclude that the lactate dosage in the CSF, although unspecified, helps to distinguish the infectious processes of the CNS.
KEY WORDS: lactate, cerebrospinal fluid, infectious diseases, AIDS.
* Avaliação crítica da dosagem de lactato no líquido cefalorraqueano em moléstias infecciosas do sistema nervoso central (Resumo) Dissertação de Mestrado. Faculdade de Medicina da Universidade de São Paulo (Área: Neurologia). Orientador: José Antonio Livramento.
** Address: Praça Amadeu Amaral 47 / 33, 01327-010 São Paulo SP, Brasil.