Several metabolites in the cerebrospinal fluid, including glucose, pyruvate and lactate, have a high diagnostic accuracy for central nervous system (CNS) infections, especially bacterial meningitis. Combinations of metabolites further improve diagnostic performance, even surpassing that of leukocyte count alone. This is the conclusion of neurologist Matthijs Brouwer and fellow researchers from Amsterdam UMC in the journal Annals of Neurology.
A CNS infection is a medical emergency that requires rapid diagnosis and immediate treatment. Currently, the best predictor for a CNS infection is an increased leukocyte count in CSF. “But in about half of the patients in whom no CNS infection is ultimately found, the leukocyte count in CSF is also increased,” says Brouwer. “And in some patients with a CSF infection, the leukocyte count is even normal.”
“We have an urgent need for new diagnostic markers for CNS infections”
Neurologist Matthijs Brouwer
Gold standard
The gold standard for detecting a CNS infection is detecting the pathogen in CSF by culture or nucleic acid amplification test, such as polymerase chain reaction (PCR). “However, it takes some time before a CSF culture becomes positive,” Brouwer indicates. “In addition, the yield of the culture strongly depends on the pathogen and any pretreatment with an
To register
Sign up for free to access DOQ, where healthcare professionals share knowledge and vision.
The Archynetys Health Desk covers public health, medical research, healthcare systems, wellness trends, and science-backed developments that affect readers globally. This desk applies added care to sourcing, evidence, nuance, and plain-language explanation, especially on high-impact health topics.
