CSF

Question 1

Specimens of CSF

Answer 1

• 4 specimens:
• 1st: chemical & immunologic
• 2nd: Hematology (CC & differential)
• 3rd: Micro
• 4th: Hold for repeat cell count

Question 2

Organism cause meningitis

Answer 2

1. Neonatal: GBS, E.coli, Listeria, other GN
2. 6m-5y: N. meningitidis, S. pneumoniae, H. influenzae
3. 5y-40y: N. meningitidis (45%), S. pneumoniae (20%)
4. > 40y: S. pneumoniae (50%), S. aureus, N. meningitidis, Listeria & other GN (in elderly)

Question 3

Viruses cause meningitis

Answer 3

• Enteroviruses
• Mumps, measles
• Herpes
• LCM
• HIV
• Adernovirus
• Arbovirus

Question 4

Tuberculosis meningitis

Answer 4

• Mycobacterium tuberculosis
• Consequence of reactivated infection in lungs and other organs
• Suspected in AIDS and previously exposed patient

Question 5

Fungal meningitis

Answer 5

• In immunocompromised patients
• Cryptococcus neoformans
• Coccidioides
• Histoplasma
• Candida
• Blastomyces
• Zygomycetes

Question 6

Other bacteria agent

Answer 6

• Spirochetes: T. pallidum, B. burgdorferi, Leptospira
• Nocardia
• Brucella

Question 7

Protozoa & Helminths

Answer 7

• Toxoplasma
• Naegleria
• Angiostrongylus
• Baylisascaris
• Strongyloides

Question 8

CSF handling

Answer 8

• Kept at RT (only viral studies accept refrigerate)

- GS & culture: STAT

Question 9

CSF catheter-associated infection

Answer 9

• CoNS & Cutibacterium acnes

- Route: At the time of surgery, hematogenous spread from distant site, spread from a nearby source

Question 10

Other tests for CSF

Answer 10

• Direct latex agglutination
• Direct bacterial, fungal, viral PCR primer sets
• BioFIRE: 14 targets in 1 hour