CSF/blood glucose ratio and bacterial meningitis without pleocytosis in a potentially immunocompromised host

Hypoglycorrhachia (abnormally low cerebrospinal fluid glucose content) eludes exact numerical definition, largely because of the dynamic equilibrium between blood and CSF glucose. A group of 181 pediatric patients with a CSF glucose less than 50 mg/100 ml or a CSF/blood glucose ratio less than 0.50 were studied. Hypoglycorrhachia was present in patients with bacterial meningitis, aseptic meningitis, meningeal carcinomatosis, subarachnoid hemmorrhage, and hypoglycemia. Markedly diminished CSF glucose values were seen primarily in patients with bacterial meningitis. Higher CSF/blood glucose ratios predominated in those with hypoglycemia and neonates with low-normal bloo sugars. Following bacterial meningitis and hypoglycemia, aseptic meningitis (including five children with documented enterovirus meningitis and one with documented mumps meningitis) was the third most common cause of hypoglycorrhachia in children. When readily available, positive CSF viral cultures may allow early cessation of antibiotic therapy in two types of patients with meningitis and hypoglycorrhachia: (1) those receiving previous recent antibiotic therapy, and (2) those with CSF findings more typical of a bacterial meningitis.

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Hypoglycorrhachia after Subarachnoid Hemorrhage

Neurosurgery ◽

10.1227/00006123-198101000-00002 ◽

1981 ◽

Vol 8 (1) ◽

pp. 7-9 ◽

Cited By ~ 12

Author(s):

Frederick M. Vincent

Keyword(s):

Cerebrospinal Fluid ◽

Blood Glucose ◽

Subarachnoid Hemorrhage ◽

Glucose Concentration ◽

Spinal Fluid ◽

Glucose Ratio

Abstract The cerebrospinal fluid (CSF) of 33 patients with a nontraumatic subarachnoid hemorrhage was analyzed to determine whether hypoglycorrhachia occurred frequently after a subarachnoid hemorrhage. Twenty-three patients (70%) developed an abnormally low CSF glucose concentration or a lowered CSF-blood glucose ratio after their hemorrhage. Thus, hypoglycorrhachia seems to be a common spinal fluid finding after subarachnoid hemorrhage.

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A NEW PRINCIPLE FOR THE COMPARISON OF INSULIN SECRETORY RESPONSES

Acta Endocrinologica ◽

10.1530/acta.0.0740511 ◽

1973 ◽

Vol 74 (3) ◽

pp. 511-523 ◽

Cited By ~ 10

Author(s):

Klaus Johansen

Keyword(s):

Blood Glucose ◽

Plasma Insulin ◽

Intravenous Glucose ◽

Endogenous Insulin ◽

Glucose Ratio ◽

Insulin Secretagogues ◽

Plasma Insulin Levels ◽

Young Subjects ◽

Insulin Secretory Response ◽

Selection Of

ABSTRACT A new principle for the comparison of insulin secretory response has been devised. It consists in the selection of groups of subjects with identical glucose tolerance when subjected to the same amount of oral and intravenous glucose and of intravenous tolbutamide. In this way the problems and assumptions inherent in the use of the insulin/glucose ratio and the administration of different amount of insulin secretagogues have been avoided. Using this new method of comparison of insulin secretory responses it has been demonstrated that young people maintain the same blood glucose level after stimulation with much smaller plasma insulin levels than their older counterparts, i. e. young non-diabetic and diabetic subjects seem to be more 'sensitive' to endogenous insulin than the old, alternately the old subjects are more 'resistant' to endogenous insulin than young subjects.

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