Cerebrospinal Fluid White Cell, Glucose and Protein Changes during the Treatment of Haemophilus influenzae Meningitis

Abstract

298 cerebrospinal fluid (CSF) samples obtained from 116 children with ongoing Haemophilus influenzae meningitis were analyzed in order to determine the kinetics of the white blood cell (WBC) count and the glucose and protein concentrations—parameters for which there are no “reference values” available for the convalescence period of meningitis. The values determined during the first 10 days of treatment are presented as percentile distribution graphs. CSF WBC counts increased slightly for the first 24 h but declined thereafter without reaching, however, the normal value (≤5/μl) within 10 days in the majority of cases. Low CSF glucose concentrations usually increased to a normal or almost normal level within 48 h. CSF protein concentrations declined steadily throughout the treatment. Extremely high CSF WBC or low CSF glucose concentrations suggested neurological complications or treatment failure. The value of sequentially determined CSF WBC, glucose and protein in monitoring recovery from H. influenzae meningitis is, however, so vague that routine spinal taps do not seem indicated after CSF has become sterilized.