Cerebro-spinal Lactate Status in Childhood Pyogenic Meningitis in Nigeria

This study was undertaken to ascertain the status of cerebrospinal (CSF) lactate level in Nigerian children with pyogenic meningitis. Forty patients aged from 1 month to 12 years with proven meningitis were the subjects in the study which lasted 8 months. All the patients who had pyogenic meningitis had mean cerebrospinal lactate level over 25 mg/dl. The patients who recovered with neurological deficit had higher level of cerebrospinal lactate than those who recovered without any neurological deficit, on admission and on-discharge, although the differences were not statistically significant. The patients who died had persistently high mean CSF lactate on admission and at death. The study suggests that persistently elevated CSF lactate in cases of pyogenic meningitis receiving adequate antibiotic therapy might indicate poor prognosis with increased mortality. It is not being suggested that CSF lactate determination should replace the conventional tests for meningitis. However, it can provide pertinent, rapid, and reliable diagnostic information, and can also provide useful evaluation information at different stages of treatment of proven meningitis with appropriate antibiotics.