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Intensive Care Medicine
Published in: Intensive Care Medicine 8/2006

01-08-2006 | Correspondence

Distinguishing bacterial from viral meningitis: the critical importance of the CSF lactic acid: author's reply

Authors: François G. Brivet, Frédéric M. Jacobs

Published in: Intensive Care Medicine | Issue 8/2006

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Excerpt

Sir: We thank Dr. Cunha for his attention to our multivariate approach of community-acquired bacterial meningitis [1]. He suggests that combining clinical presentation with the clinical severity is helpful in distinguishing bacterial from viral meningitis according to the study by Durand et al. [2], that meningoencephalitis is rare during bacterial meningitis (BM), that CSF lactate values are of interest for the diagnosis, and thus that there was no need to use a multivariate approach. …
Literature
1.
Brivet FG, Ducuing S, Jacobs F, Chary I, Pompier R, Prat D, Grigoriu BD, Nordmann P (2005) Accuracy of clinical presentation for differentiating bacterial from viral meningitis in adults: a multivariate approach. Intensive Care Med 31:1654–1660PubMedCrossRef
2.
Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS, Swartz MN (1993) Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med 328:21–28PubMedCrossRef
3.
Miner JR, Heegard W, Mapes A, Biros M (2001) Presentation, time to antibiotics, and mortality of patients with bacterial meningitis at an urban country medical center. J Emerg Med 21:387–392PubMedCrossRef
4.
Tunkel AR, Scheld WM (1995) Acute bacterial meningitis. Lancet 346:1975–1980CrossRef
5.
Behrman RE, Meyers BR, Mendelson MH, Sacks HS, Hirschman SZ (1989) Central nervous system infections in the elderly. Arch Intern Med 149:1596–1599PubMedCrossRef
6.
Elmore JG, Horwitz RI, Quagliarello VJ (1996) Acute meningitis with a negative Gram's stain: clinical and management outcomes in 171 episodes. Am J Med 100:79–84CrossRef
Metadata
Title
Distinguishing bacterial from viral meningitis: the critical importance of the CSF lactic acid: author's reply
Authors
François G. Brivet
Frédéric M. Jacobs
Publication date
01-08-2006
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 8/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-006-0211-9

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