Case of secondary purulent meningitis in background of sepsis

Abstract

The relevance of the work is associated with the identification of diagnostic capabilities of the automated analysis of biological fluids (blood and cerebrospinal fluid) in sepsis, complicated by bacterial meengitis. The purpose of the work is to analyze the results of dynamic monitoring of cerebrospinal fluid and venous blood samples from the perspective of searching foarkers of an unfavorable prognosis. Materials and methods. The work was carried out on the basis of Regional Clinical Hospital No. 2 (Krasnodar city, Russia). The patient’s medical history was retrospectively analyzed with the main clinical diagnosis of the econdary purulent meningitis against sepsis. Samples of biological fluids were repeatedly tested on a Sysmex XN-1000 analyzer (Sysmex, Japan). A number of traditional and new parameters of the general blood test were evaluated. In particular, the dynamics of the following indicators was analyzed: the content of leukocytes (WBC, 10⁹/l), the number of immature granulocytes (IG, %); the absolute number of reticulocytes (Ret, 10¹²/l); delta hemoglobin level (D-He, pg); relative number of high fluorescent lymphocytes (HFCL, %). As for the cerebrospinal fluid, all parameters of the automated analysis of biological fluids were analyzed: total cytosis index (TCN, 10⁹/l), leukocyte count (WBC-BF, 10⁹/l), number of mononuclear cells with high fluorescence (HF, % and HF, 10⁹/l), the absolute and relative number of leukocyte populations. According to the data obtained, the following can be distinguished as laboratory markers associated with an unfavorable prognosis: lack of positive dynamics regarding the absolute neutrophil content in cerebrospinal fluid; neutrophilic leukocytosis without a significant left shift in the general analysis of blood; an increase in the number of reticulocytes, not accompanied by an increase in reticulocytes of immature fractions.