Differential diagnosis between the various forms of meningeal or central nervous system disease has not become simpler as our knowledge of the pathology and chemistry of these conditions has increased. While it is relatively easy to diagnose clinically the acute inflammatory or purulent types of disease from those of a less acutely inflammatory nature, the differentiation between the diseases comprising each group is still clinically and chemically confused. The clinical picture of epidemic, pneumococcal, influenzal or streptococci meningitis is, as a rule, distinct from that of epidemic encephalitis, anterior poliomyelitis, polioencephalitis or tuberculous meningitis.Bacteriologically, the distinction in the former group is clearly enough defined. Chemically, the evidence is less definite in both groups. Differentiation between meningitis and meningismus, tetany and certain types of birth injuries at times may be very difficult. The determination of the primary lesion in instances of combined cardiorenal and meningeal conditions is often
WILCOX HB, LYTTLE JD, HEARN JE. THE CHEMICAL COMPOSITION OF THE SPINAL FLUID: DIAGNOSTIC VALUE. Am J Dis Child. 1925;30(4):513–540. doi:10.1001/archpedi.1925.01920160067007
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