RESUMO
Cerebrospinal fluid (CSF) lactate was determined in 245 patients by means of a rapid enzymatic method (Monotest Lactate). The mean value was 1.61 mmol/l (range 0.79-3.33) in 104 control patients, 2.06 mmol/l (range 0.76-4.31) in 121 patients with aseptic meningitis, and 8.18 mmol/l (range 1.77-19.21) in 20 patients with bacterial meningitis. In most of the patients CSF protein and the CSF/blood glucose quotient were also determined. Lactate and glucose quotient differentiated equally well between aseptic and bacterial meningitis while protein was somewhat less useful. Suitable values for discrimination between aseptic and bacterial meningitis were judged to be 3.0 mmol/l for CSF lactate, 1.0 g/l for CSF protein and 0.5 for the glucose quotient. Combinations of tests improved the diagnostic accuracy in aseptic but not in bacterial meningitis. In 2 patients with bacterial meningitis all tests failed. CSF lactate may be used as a supplementary aid in the diagnosis of meningitis. Its diagnostic efficacy was equal to but not better than that of the traditional methods.
Assuntos
Lactatos/líquido cefalorraquidiano , Meningite Asséptica/diagnóstico , Meningite/diagnóstico , Adolescente , Adulto , Idoso , Glicemia/análise , Líquido Cefalorraquidiano/citologia , Proteínas do Líquido Cefalorraquidiano/análise , Criança , Pré-Escolar , Diagnóstico Diferencial , Glucose/líquido cefalorraquidiano , Humanos , Lactente , Ácido Láctico , Contagem de Leucócitos , Meningite/líquido cefalorraquidiano , Meningite Asséptica/líquido cefalorraquidiano , Pessoa de Meia-IdadeRESUMO
Platelet counts, P&P, factor V and fibrin/fibrinogen degradation products (FDP) in serum were determined in 96 patients with 100 episodes of acute infections. The aim of the study was to evaluate the possible correlation between the tests, separately and in combination, and the outcome of the patients. The prognostic value was found to be dubious (0.05 greater than P greater than 0.01) as regards both a low platelet count and a decreased level of P&P and very low (P greater than 0.2) as regards factor V. On the other hand, the demonstration of a raised S-FDP as well as the presence of more than one pathological test was of distinct prognostic value (P less than 0.001). It is concluded that coagulation tests are useful as supportive aids in the prognostic evaluation of patients with acute infectious diseases.
Assuntos
Fatores de Coagulação Sanguínea , Plaquetas , Produtos de Degradação da Fibrina e do Fibrinogênio , Infecções/sangue , Doença Aguda , Adolescente , Adulto , Idoso , Contagem de Células Sanguíneas , Fatores de Coagulação Sanguínea/análise , Testes de Coagulação Sanguínea , Criança , Pré-Escolar , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Sepse/sangueRESUMO
168 patients with bacteremia seen in 1965-1969 were studied with regard to mortality rate, age and sex distribution, sources of infection, predisposing factors and infecting organisms. Special attention was drawn to outside hospital originating bacteremia vis-a-vis hospital-acquired bacteremia. In general, the results obtained were essentially in agreement with earlier experiences elsewhere. The most striking observations were, firstly, the grave prognosis associated with hospital-acquired bacteremia and, secondly, the dominant role played by gram-negative bacilli.
