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Retrospective study of differential diadynamic criteria in 54 patients with acute bacterical and cryptococcal meningitis


He binZhao zhong-xin, Shao fu-yuan. Department of Neurology, Changzheng hospital, Second Military Medical University, Shanghai, 200003.

Abstract: Department of Neurology, Changzheng hospital, Second Military Medical University, Shanghai, 200003
Summary: Objective: To analyze the quantitive standards and sensitivity of multiple laboratory marker in the differential diagnosis of bacterial or cryptococcal meningitis and try to discuss its clinical value. Method: 54 patients with acute bacterial and cryptococcal meningitis were retrospectively analyzed . Peripheral blood picture and laboratory findings of cerebrospianl fluid(CSF) were compared respectively. Result: Acute bacterical meningitis was hardly differentiated from cryptococcal one by peripheral blood polymorphonuclear leukocytes percentage and CSF glucose level. But acute bacterical meningitis should be highly suspected in patients with peripheral WBC count more than 2.0?109/L , more than 1000.0?106/L CSF leukocytes, more than 500.0?106/L CSF polymorphonuclear leukocytes, CSF glucose level less than 1.7mmol/L, a CSF-blood glucose ratio less than 0.35, or a CSF protein level greater than 2.0g/L. The probability of CSF protein elevation in acute bacterial meningitis was positively corrected with blood glucose level. Conclusion: the quantitive standard and main differential points of multiple laboratory marker help to increase the diagnostic accuracy of acute bacterical meningitis from cryptococcal one and decrease the rate of missed diagnosis.
Key word: bacterical meningitis cryptococcal meningitis cerebrospianl fluid diferential diagnosis

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