THE cerebrospinal fluid (CSF) changes characteristically associated with bacterial meningitis include an increase in protein and a decrease in glucose content. The former change is usually attributed to inflammatory changes in the meninges in association with a generalized increase in the permeability of the membranes which comprise the "blood-CSF barrier."1 This permeability change presumably results in the greater diffusion of plasma proteins into CSF. The decrease in glucose content has been attributed to glycolysis by phagocyting polymorphonuclear leukocytes in the presence of bacteria,2 as evidenced by increased concentrations of lactic acid in purulent fluids.3 Another factor has been suggested, namely, that a variety of meningeal disorders may be associated with an alteration in the transfer of glucose between blood and CSF.4-6 Glucose transfer has been shown to be dependent upon a membrane carrier system, which has the characteristics of facilitated diffusion.7
These studies were
Prockop LD, Fishman RA. Experimental Pneumococcal Meningitis: Permeability Changes Influencing the Concentration of Sugars and Macromolecules in Cerebrospinal Fluid. Arch Neurol. 1968;19(5):449–463. doi:10.1001/archneur.1968.00480050019001
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