Retrospective and differential diagnostic study of tuberculous and viral meningitis

Objective To analyze the quantitive standards and main differential points of multiple laboratory markers in tuberculous and viral meningitis and try to find out the effecting factors among the patients with tuberculous meningitis whose cerebrospinal fluid (CSF) protein significantly increase. Methods Of 60 patients with tuberculous and viral meningitis were analyzed retrospectively. Clinical symptomes peripheral blood picture and laboratory findings of CSF were compared respectively. The logistic regression method was employed to analyze the factors of significant elevation of the CSF protein in patients with tuberculous meningitis.Results Tuberculous meningitis was hardly differentiated from the viral one by clinical symptoms, peripheral blood picture, blood glucose , total CSF white blood cells and its classification. But compared to the viral meningitis , tuberculous meningitis should be highly suspected in patients with a CSF glucose level less than 2.5mmol/L, a CSF blood glucose ratio less than 0.50, a CSF protein level greater than 1.0g/L and a CSF chloride level less than 120.0mmol/L. The sensitivity of the laboratory markers was as follows: CSF blood glucose ratio less than 0.50 CSF glucose level less than 2.5mmol/L, CSF protein level greater than 1.0g/L CSF chloride level less than 120.0mmol/L. Negative correlation was found between CSF protein level greater than 1.0g/L and CSF chloride level less than 122.81mmol/L. Conclusion The quantitive standard and main differential points of multiple laboratory marker help to increase both the sensitivity and the accuracy of diagnosis of tuberculous meningitis one.