Lactate dehydrogenase (LDH) was assayed in peripheral leukocytes of 32 children with bacterial meningitis, nine children with nonbacterial meningitis, and 24 age-matched, healthy controls. Leukocyte LDH activity in patients with bacterial meningitis was significantly higher than in patients with nonbacterial meningitis (p < 0.01) and normal controls (p < 0.001). Eighty-eight percent of the patients with bacterial meningitis had leukocyte LDH values exceeding, 150 units/106 WBC, the upper limit of normal value for controls. Nitroblue tetrazolium (NBT) dye tests performed on 23 patients with bacterial meningitis were elevated in ten patients (43%). The elevation of leukocyte LDH activity in patients with bacterial meningitis appears to be independent of the number of circulating granulocytes or the presence of bacteremia. A major factor which appeared to influence the leukocyte LDH activity was the duration of adequate antibiotic therapy. Sequential determinations showed a return of the LDH values to normal approximately ten days after the initiation of therapy. A rise in leukocyte LDH was encountered in two patients with subdural effusion. The finding of significantly elevated leukocyte LDH values in three newborn infants with neonatal meningitis and sepsis suggests that this test may be of value in the diagnosis of neonatal sepsis.

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