All issues > Volume 14(10); 1971

Original Article

J Korean Pediatr Soc. 1971;14(10):644-652. Published online October 31, 1971.

Study of the Relationship Between Glucose Level in Cereberospinal Fluid and in Blood of Normal Children and Patients with Meningitis

Jae Seung Lee¹

¹Department of Pediatrics Yonsei University College of Medidine

Abstract

Menigitis, despite the development of effective antibiotics, is still a disease o£ high mortality and morbidity in pediatrics(Light,1967). It is a disease attracting a great deal of attention by pediatricians. Sometimes meningitis in childhood shows atypical clinical symptoms and signs. The occurence of bacterial meningitis in the neonatal period and infants creates special problems in early diagnosis, because the signs of meningeal irritation are often minimal or nonexistent (Weliman, 1967). Examination of the spinal fluid is the only method for immediate confirmation of the diagnosis of meningitis/ One of the most characteristic abnormalities of cerebrospinal fluid in patients with bacterial and tuberculous meningitis is a decrease in glucose content (Menkes, 1969). Even though the reading of the cerebrospinal fluid may be abnormal (i.e. below 40mg%) no definite diagnosis can be made by this examination alone. Furthermore in general practice the clinical symptoms and laboratory data are often obscured because of the indiscriminate use or poor administration of antibiotics. Studies were carried out on 58 meningitis patients and 33 normal or non-meningitis patients as control whose age ranged from birth to 15 years old divided into 4 experimental group as follows Group I.normal or noneningitis patients 33cases Group H. purulent meningitis patients 20 cases Group QI. tuberculous eningitis patients 30 cases Group W. aseptic meningitis patients 8 cases Spinal tapping was performed before treatment in all patients. The glucose concentration was measured by Nelson Somogyi microniethod (Nelson, 1944, Somogyi, 1945). The following results were obtained： 1. Blood glucose concentration in all experimental groups was around 86 mg%. 2. Glucose concentration of cerebrospinal fluid was normal in group W as compared to 55. 73±2. 23 mg% in group I but was significantly decreased to 18. 28±2. 00 and 24. 61 ±2. 03nig% in group I and group M, respectively. 3.In group I glucose concentration of cerebrospinal fluid and blood was closely related (r=0. 755) but in group Q, M and W the relationship was markedly dissociated. 4. The ratio of glucose concentration of cerebrospinal fluid to that of blood was 0. 65±0. 01 in group I, 0. 22 ±0. 02 in group I, 0. 28±0. 22 in group HI and 0. 64 ±0. 02 in group W. On the basis of the above results it may be concluded that the glucose concentration of cerebrospinal fluid in meningilis is a good index of diagnosis and the relationship between blood and cerebrospinal fluid glucose concentration can be a helpful index for its diagnosis as well.

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