Iranian Journal of Pathology

Cerebrospinal Fluid Analysis in Patients with Post-neurosurgical Procedures: Meningitis vs. Non-meningitis

Document Type : Original Research

Authors

Mehdi Zeinalizadeh 1
Maryam Shadkam 2
Pegah Afarinesh Khaki 3
Alireza Abdollahi 4
Masoumeh Douraghi 5
Mohammadreza Salehi 6

1 Department of Neurological Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

3 Central Laboratory of Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

5 Medical Bacteriology Section, Department of Pathobiology, School of Public Health. Tehran University of Medical Sciences, Tehran, Iran

6 Research Center for Antibiotic Stewardship & Antimicrobial Resistance, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.30699/ijp.2024.2019741.3240
Abstract
Background & Objective: Cerebrospinal fluid (CSF) analysis is helpful in the diagnosis of infections of the central nervous system (CNS), especially after neurosurgical procedures. This study aimed to evaluate the diagnostic value of CSF markers for diagnosis of post-neurosurgical meningitis (PNM).
Methods: Patients with neurosurgical procedures whose CSF was obtained for any reason (meningitis and non-meningitis) during 2020 and 2022, at Imam Khomeini Hospital Complex, Tehran, Iran, were included. Serum and CSF lactate dehydrogenase (LDH), glucose, protein, white blood cells (WBC), red blood cells (RBC), and CSF/serum glucose and LDH ratio were compared between the patients who were diagnosed with PNM and those without meningitis.
Results: A total of 115 patients were included, of whom 23 patients were diagnosed with PNM and 92 with non-meningitis. No significant differences were observed in patients’ age, gender, and underlying diseases between the two groups. Findings showed a significantly (P=0.029) lower level of the mean CSF glucose (59.5 mg/dL ±33.9) in patients with meningitis than in patients without meningitis (76.8 mg/dL ± 37.5). The mean CSF/serum glucose ratio was 43.7% in the meningitis group and 56.3% in the non-meningitis group (P=0.008). The mean WBC count and neutrophil dominance were significantly higher in the meningitis group. No significant differences were observed in CSF LDH, Protein, and RBC between the two groups.
Conclusion: A CSF glucose level of less than 60 mg/dL, a CSF/serum glucose ratio of less than 0.44, and a higher CSF WBC and neutrophil count can help diagnose PNM.

Keywords

Cerebrospinal fluid (CSF) analysis, CSF glucose, CSF leukocyte count, Post-neurosurgical meningitis

Subjects

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Iranian Journal of Pathology
Volume 19, Issue 3
Summer 2024
Pages 342-347

  • Receive Date 17 January 2024
  • Revise Date 04 February 2024
  • Accept Date 19 February 2024

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