The full content of Annals is available to subscribers

Subscribe/Learn More  >
Original Research |

Ventricular Fluid and the Management of Coccidioidal Meningitis

[+] Article, Author, and Disclosure Information

Supported in part by grants APO 0628 and 01239, National Institutes for Environmental Health, and Training Grant 5 TO1 AI 00384, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.; and in part by contract DADA 17-69-C-9061, the Armed Forces Epidemiological Board (U.S. Army R and D), Commission on Acute Respiratory Diseases, Washington, D.C.

▸Requests for reprints should be addressed to Elliot Goldstein, M.D., Department of Internal Medicine, School of Medicine, University of California at Davis, Davis, Calif. 95616.

Davis and Sacramento, California

Ann Intern Med. 1972;77(2):243-246. doi:10.7326/0003-4819-77-2-243
Text Size: A A A

An Ommaya reservoir is often used to administer chemotherapy in the treatment of fungal meningitis. Since management of these chronic infections requires periodic analyses of cerebrospinal fluid, there is a tendency to obtain specimens from this site rather than from repeated lumbar taps. In three cases of meningitis due to Coccidioides immitis, one of which was complicated by a staphylococcal superinfection, analysis of ventricular fluid obtained from the reservoir was diagnostically misleading. This fluid usually showed protein concentrations of less than 30 mg/100 ml, glucose concentrations of more than 57 mg/100 ml, falsely low complement-fixing antibody titers, and small numbers of cells. Spinal fluid from the lumbar space showed the characteristic abnormalities associated with meningitis, in protein, glucose, and cellular constituents. This masking effect is caused by physiological differences between ventricular and lumbar fluid and can be great enough to limit the diagnostic value of ventricular fluid.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.