CSF lactate

Q: What is the importance of measuring lactate level in Cerberospinal fluid (CSF)?

Answer:  Although not usually measured but measuring CSF lactate is a great way of differentiating bacterial and viral meningitis. The diagnostic accuracy of CSF lactate is found to be superior to CSF white blood cell count, glucose, and protein concentration in such differentiation. To note ideally lactate should be measured in CSF prior to the administration of antibiotics. 

Said that Lactate in CSF is not exclusively for bacterial meningitis. It can be elevated in other CNS diseases.

#neurology

References:

Huy NT, Thao NT, Diep DT, et al. Cerebrospinal fluid lactate concentration to distinguish bacterial from aseptic meningitis: a systemic review and meta-analysis. Crit Care 2010; 14:R240.

Sakushima K, Hayashino Y, Kawaguchi T, et al. Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis. J Infect 2011; 62:255.