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Adult (≥ 18 years) patients admitted to the University Hospital North Zealand, in Copenhagen, Department of Infectious diseases between June 2016 and August 2019 clinically suspected of having meningitis, encephalitis, or Lyme neuroborreliosis were included. Nordsjællands Hospital services a population of 320.000 individuals. Patients were included prospectively in an observational study and samples were analyzed retrospectively.
CSF- and blood biochemistry results were obtained from the laboratory database LABKA II (Dedalus Healthcare ApS, Denmark). Blood biochemistry data obtained on the same day as lumbar puncture was performed were included. Data on microbiology was retrieved from databases for the individual departments.
Clinical data were collected from patient medical records including clinical datasheets, nurse registration files, and discharge records.
Outcome at discharge was categorized using the Glasgow Outcome Scale (GOS): (1) death; (2) vegetative state; (3) severe sequelae and dependency upon others in daily life; (4) moderate sequelae but with the ability to live independently; and (5) no or mild sequelae. An unfavorable outcome was defined as a GOS score of 1–4.
The included meningitis, encephalitis, or Lyme neuroborreliosis patients were ≥ 18 years of age and had a clinical appearance suggestive of CNS infection (any combination of neck stiffness, fever, headache or altered mental status or neurological symptoms) with ≥10 x 106 cells/L in the CSF in combination with specific criteria as described below.
The control group was patients ≥ 18 years of age admitted under suspicion of CNS infection but with normal CSF biochemistry (CSF white blood cell count under 5 x 106 cells/L, lactate under 2,4 mmol/L and protein < 0,8 g/L with no sign of blood contamination in the CSF) and with clinical improvement without specific meningitis treatment.

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