Csf Continuation Flashcards
Normal Glucose with High Lymphocytes –
VIRAL MENINGITIS
Low glucose with High neutrophils – indicative of
BACTERIAL MENINGITIS
Low glucose with High Lymphocytes suggestive to
TUBERCULAR MENINGITIS AND FUNGAL MENINGITIS
Valuable aid in the diagnosis and management of meningitis cases
Csf lactate
Inversely proportional to glucose
Csf lactate
Normal csf lactate
10-22 mg/dL
Produced from ammonia and alpha ketoglutarate by the brain cells
Glutamine
The normal concentration of glutamine is
8 to 18 mg/dL
75% of children with __________ have elevated glutamine levels
Reye’s syndrome
Csf chloride Normal value:
125-135 mg/dl
LD 2 and LD 3
Lymphocytes
LD 1 and LD 2
Brain tissues
LD 4 and LD 5
neutrophil
Employed as a CONFIRMATORY rather than a diagnostic procedure
Csf culture
there are certain procedures that may serve as a preliminary diagnosis in csf culture
- Gram Stain
- Acid-Fast Stain
- India Ink
- Latex agglutination
• Routinely performed on CSF from ALL SUSPECTED cases of meningitis
• Performed on concentrated specimens ONLY
• Recommended for the detection of microorganisms
Gram stain
• Not routinely performed
• A positive report is extremely valuable
Acid fast stain
Performed with possible cases of FUNGAL Meningitis
India ink
India ink detect ___________
Cryptococcus neoformans
Cryptococcus neoformans pattern in gram stain
Starburst pattern
- Used to detect the presence of Cryptococcus neoformans antigen in serum and CSF
- More sensitive than India Ink
LATEX AGGLUTINATION
Primarily used in addition to detecting microorganisms as a tool in diagnosing NEUROSYPHILIS
SEROLOGIC TESTING
- RECOMMENDED TEST by the CDC in diagnosing Neurosyphilis.
- Less sensitive than Fluorescent treponemal antibody-absorption (FTA-ABS
VDRL (Veneral Disease Research Laboratories
“Positive serologic tests _______ be confirmed by culture and demonstration of the organism in India Ink preparation”
Should
Group B Strep and GNB
Birth to 1 month old
1month to 5 years old
H.influenzae
5 years old to 29 years old
N. meningitidis
> 29 years old
S. pneumoniae
newborn, elderly
L. monocytogenes
Features:
a. Increased WBC count (neutrophil)
b. Increased Protein
c. Decreased Glucose
d. >35 mg/dl lactate
e. (+) bacteria in gram stain
f. (+) Limulus Lysate test
BACTERIAL MENINGITIS
Features:
a. Increased WBC count (Lymphocyte)
b. Increased Protein
c. Normal Glucose
d. Normal Lactate
VIRAL MENINGITIS
Features:
a. Increased WBC count (Monocyte, Lymphocyte)
b. Increased Protein
c. Decreased Glucose
d. >25 mg/dL Lactate
e. (+) Pellicle Formation/ Clot Formation (in specimen placed in refrigerator for 12-24 hours)
TUBERCULAR MENINGITIS
Features:
a. Increased WBC count (Monocyte, Lymphocyte)
b. Increased Protein
c. Decreased Glucose
d. >25 mg/dl Lactate
e. (+) India Ink – demonstration of capsule
FUNGAL MENINGITIS
• Caused by free-living amoeba
• Used of Acridine orange stain (amoeba stains brick-red)
• Naegleria fowleri
PRIMARY AMOEBIC MENINGOENCEPHALITIS (PAM)
