German guidelines on community-acquired acute bacterial meningitis in adults

Table 1 CSF Parameters in Meningitis¹

Parameter in CSF	bacterial [13]	viral [38]	tuberculous [39]
cell count/µl	> 1000	< 1000	< 1000
cytology	granulocytes	lymphocytes ²	mixed
CSF-serum-glucose-index	decreased	normal	moderately decreased
lactate (mmol/l)	> 3,5	< 3,5	> 3,5
total protein (mg/dL)	> 100	< 100	> 100
blood-CSF-barrier (CSF-serum albumin ratio)	severely disrupted	normal	severely disrupted
intrathecal Ig-synthesis	IgA, IgG	IgG	IgA

¹The actual CSF constellations can differ, especiall in early stages of the disease. E.g., one third of the patients with acute bacterial meningitis present with a CSF cell count of < 1000/µl [13]. ²Granulocytes can dominate in early stages of a viral infections (especially in adults) [38]

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