Differential Diagnosis on Acute Bacterical and Viral Meningitis

Objective To study the quantitive standard and sensitivity of multiple laboratory marker in the differential diagnosis of accute bacterial or viral meningitis, and try to discuss its clinical value. Methods 26 patients with acute bacterial meningitis and 31 patients with viral meningitis were retrospectively analyzed. Clinical symptoms, peripheral blood picture, blood glucose and the leukocyte number of cerebrospianl fluid (CSF), protein, and glucose were compared respectively. Results Acute bacterical meningitis was hardly differentiated from acute viral one by clinical symptoms and peripheral blood picture, but acute bacterical meningitis should be highly suspected in patients with a CSF glucose level 1.7mmol/L,CSF leukocytes2000. 0×106/L,CSF polymorbhonuclear leukocytes1000×106/L, protein level2.0g/L, the ration of CSF and bolld glucose ratio0.35, the sensitivity of the subsequence of the laboratory markers were as follows; CSF-blood glucose ratio,, CSF glucose level, CSF protein level and CSF polymorphonuclear leukocytes counts, CSF leukocytes counts. Conclusion The above quantitive standard contributed to increase the diagnostic sensibility, accuracy of acute bacterical and viral meningitis, and decrease the rate of misdiagnosis.