It is reported in the literature that limulus test is sensitive to the diagnosis of meningitis caused by gram-negative bacteria, and generally, the false negative result is less than 1%. Terg et al.'s preliminary screening showed that cerebrospinal fluid endotoxin level>1.200pg/ml was closely related to the occurrence and death of shock in children with gram-negative meningitis.

There is a certain correlation between the quantitative value measured by endotoxin and the clinical process, which is of great significance in revealing the measures to be taken in clinical practice and the prognosis. 30% of patients with bacterial meningitis have convulsions. Terg et al. found in the study of 1503 patients with meningitis that when the endotoxin in cerebrospinal fluid is more than 150pg/ml, it is easy to have convulsions. Although its mechanism is not completely clear, the local metabolism of endotoxin in cerebrospinal fluid and its effect on blood vessels is likely to be the major cause of convulsions. Animal experiments showed that intravenous injection of endotoxin into mice sensitized with Corynebacterium brevis in advance would cause convulsions. The increase in plasma endotoxin content will also be accompanied by serious EEG abnormalities. Although there are many etiological factors of dysfunction in the central nervous system, which cannot be completely attributed to endotoxin, endotoxin is certainly an important factor.

The above studies show that plasma endotoxin concentration and cerebrospinal fluid concentration are of great significance in guiding clinical treatment and estimating prognosis. If cerebrospinal fluid endotoxin ≥ 3.2 × 10-6mg/ml, it was obviously accompanied by death. If endotoxin<3.2 × 10-6mg/ml, without death.