Indications and Diagnostic Findings in Cerebrospinal Fluid (CSF) Analysis for Meningitis

Introduction

Meningitis is a serious medical condition characterized by inflammation of the meninges surrounding the brain and spinal cord. Early diagnosis and intervention are critical for optimal outcomes. Cerebrospinal fluid (CSF) analysis remains the gold standard for diagnosing meningitis, providing crucial insights into its etiology and severity.

Clinical Indications for CSF Examination

• Patients presenting with signs of meningitis: fever, headache, neck stiffness, photophobia.
• Altered mental status or signs of increased intracranial pressure.
• Suspected bacterial, viral, fungal, or tuberculous meningitis.

CSF Diagnostic Findings

Bacterial Meningitis

• Elevated white blood cell (WBC) count with predominant neutrophils.
• Decreased glucose concentration.
• Elevated protein levels.
• Positive Gram stain and culture.

Viral Meningitis

• Moderate WBC elevation, primarily lymphocytes.
• Normal or slightly decreased glucose levels.
• Moderate protein elevation.
• Negative bacterial culture.

Fungal and Tuberculous Meningitis

• Elevated WBC count, predominantly lymphocytes.
• Markedly decreased glucose concentration.
• High protein levels.
• Positive fungal culture or acid-fast bacilli.

Conclusion

CSF analysis is crucial for diagnosing and distinguishing the various forms of meningitis. Understanding its diagnostic findings allows for targeted treatment and improved patient outcomes.