Volume 88, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We validated a handheld point-of-care lactate (POCL) monitor's ability to measure lactate in cerebrospinal fluid (CSF) and diagnose bacterial meningitis in Uganda. There was a strong linear correspondence between POCL and standard laboratory lactate test results ( = 0.86; < 0.001). For 145 patients with clinical meningitis, the area under the receiver operating characteristic curve for the prediction of bacterial meningitis by CSF POCL was 0.92 (95% confidence interval = 0.85–0.99, < 0.001). A CSF POCL concentration of 7.7 mmol/L provided 88% sensitivity and 90% specificity for the diagnosis of bacterial meningitis. CSF POCL testing had excellent use in the diagnosis of bacterial meningitis, and it may be useful where CSF analyses are delayed or laboratory infrastructure is limited.


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  1. Ziai WC, Lewin JJ, III, 2006. Advances in the management of central nervous system infections in the ICU. Crit Care Clin 22: 661694.[Crossref] [Google Scholar]
  2. van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M, , 2004. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 351: 18491859.[Crossref] [Google Scholar]
  3. Petti CA, Polage CR, Quinn TC, Ronald AR, Sande MA, , 2006. Laboratory medicine in Africa: a barrier to effective health care. Clin Infect Dis 42: 377382.[Crossref] [Google Scholar]
  4. Ross D, Rosegay H, Pons V, , 1988. Differentiation of aseptic and bacterial meningitis in postoperative neurosurgical patients. J Neurosurg 69: 669674.[Crossref] [Google Scholar]
  5. Guerra-Romero L, Tauber MG, Fournier MA, Tureen JH, , 1992. Lactate and glucose concentrations in brain interstitial fluid, cerebrospinal fluid, and serum during experimental pneumococcal meningitis. J Infect Dis 166: 546550.[Crossref] [Google Scholar]
  6. Leib SL, Boscacci R, Gratzl O, Zimmerli W, , 1999. Predictive value of cerebrospinal fluid (CSF) lactate level versus CSF/blood glucose ratio for the diagnosis of bacterial meningitis following neurosurgery. Clin Infect Dis 29: 6974.[Crossref] [Google Scholar]
  7. Huy NT, Thao NT, Diep DT, Kikuchi M, Zamora J, Hirayama K, , 2010. Cerebrospinal fluid lactate concentration to distinguish bacterial from aseptic meningitis: a systemic review and meta-analysis. Crit Care 14: R240.[Crossref] [Google Scholar]
  8. Muhumuza J, Asiimwe BB, Kayes S, Mugyenyi R, Whalen C, Mugerwa RD, Boom H, Eisenach KD, Joloba ML, , 2006. Introduction of an in-house PCR for routine identification of M. tuberculosis in a low-income country. Int J Tuberc Lung Dis 10: 12621267. [Google Scholar]
  9. Scarborough M, Thwaites GE, , 2008. The diagnosis and management of acute bacterial meningitis in resource-poor settings. Lancet Neurol 7: 637648.[Crossref] [Google Scholar]
  10. Bailey EM, Domenico P, Cunha BA, , 1990. Bacterial or viral meningitis? Measuring lactate in CSF can help you know quickly. Postgrad Med 88: 217219, 223.[Crossref] [Google Scholar]
  11. Cameron PD, Boyce JM, Ansari BM, , 1993. Cerebrospinal fluid lactate in meningitis and meningococcaemia. J Infect 26: 245252.[Crossref] [Google Scholar]
  12. Genton B, Berger JP, , 1990. Cerebrospinal fluid lactate in 78 cases of adult meningitis. Intensive Care Med 16: 196200.[Crossref] [Google Scholar]
  13. Trachtenberg JD, Kambugu AD, McKellar M, Semitala F, Mayanja-Kizza H, Samore MH, Ronald A, Sande MA, , 2007. The medical management of central nervous system infections in Uganda and the potential impact of an algorithm-based approach to improve outcomes. Int J Infect Dis 11: 524530.[Crossref] [Google Scholar]

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  • Received : 23 Jul 2012
  • Accepted : 09 Oct 2012
  • Published online : 09 Jan 2013

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