We evaluated a previously proposed method to distinguish bacterial from viral or aseptic
meningitis. Cerebrospinal fluid (CSF) samples from 109 children with meningitis (67
bacterial, 23 viral and 19 aseptic) were compared on the basis of a predefined leukocyte
aggregation score (LAS). The median LAS was 32.1% (range 0-84.1%) in the bacterial group,
0% (range 0-16.6%) in the viral group and 0% (range 0-20.7%) in the aseptic group. The LAS
performed better than peripheral white cell count (WCC), serum C-reactive protein and CSF
WCC in diagnosing bacterial meningitis. It was equally as sensitive as CSF protein and serum
TNF-a, IL-ip, IL-6 and IL-8 but inferior to a combination of blood culture, CSF Gram stain
and CSF culture. Significant correlations were found between the LAS and a number of
inflammatory markers. Prior antibiotics, duration of symptoms prior to admission and
traumatic lumbar punctures did not effect the LAS. HIV-1 status lowered the score in
viral/aseptic cases. The test may be useful as an early screening tool but its sensitivity does not
surpass the currently employed methods
