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VOLUME 22 , ISSUE 4 ( 2018 ) > List of Articles

CASE REPORT

Cerebrospinal fluid lactate as a prognostic indicator in postneurosurgical bacterial meningitis and use of intrathecal colistin

Karthik Rao, Pradeep Rangappa, Ipe Jacob, Pradeepkumar Hiremath

Keywords : intrathecal colistin, postneurosurgery meningitis diagnosis,Cerebrospinal fluid lactate

Citation Information : Rao K, Rangappa P, Jacob I, Hiremath P. Cerebrospinal fluid lactate as a prognostic indicator in postneurosurgical bacterial meningitis and use of intrathecal colistin. Indian J Crit Care Med 2018; 22 (4):297-299.

DOI: 10.4103/ijccm.IJCCM_418_17

License: CC BY-ND 3.0

Published Online: 00-04-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Postneurosurgical bacterial meningitis (PNBM) is an emergency and requires early diagnosis and treatment with appropriate antibiotics. The cornerstone of diagnosis is microbiological analysis of the cerebrospinal fluid (CSF) cytochemical characteristics such as leucocyte count, CSF glucose, and protein concentration and CSF: Serum glucose ratio. However, this is often misleading in PNBM. The role of CSF lactate assay for diagnosis and prognosis has been debated. This case report looks into the serial measurement of CSF lactates in PNBM. It also looks into the role of intrathecal colistin. CSF lactate showed a steady decrease corresponding to improvement in clinical condition. Hence, CSF lactate could have a better prognostic value than other conventional markers in PNBM. Intrathecal colistin, in conjunction with the standard antibiotics, can contribute to a quick resolution of the condition.


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