Podcast 556:  CSF - What is it good for?

<p><strong>Contributor: Eric Miller, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">A cell count is performed on tubes 1 and 4 to account for changes that may occur from blood entering the first sample from the needle insertion</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Tube 2 and 3 are usually used for the other studies like protein levels, glucose levels and gram staining </span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Protein levels are often elevated in bacterial meningitis but can be helpful in diagnosis conditions like multiple sclerosis</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Glucose levels are typically low in bacterial meningitis due to the use of glucose by bacteria</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Cell counts above 3-5 cells are typically abnormal, but cell counts can vary widely depending on the type of meningitis (viral vs. bacterial) and how long the infection has been present.</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Cell type and differential can indicate viral vs. bacterial meningitis </span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Neutrophils are more associated with bacterial causes</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Lymphocytes are more associated with viral etiologies</span></li> </ul> </li> <li style="font-weight: 400;"><span style="font-weight: 400;">CSF cultures are used to identify the cause of bacterial meningitis but can take days to result.</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">A gram stain can help determine if any bacteria are present as well as cell types present.</span></li> </ul> <p><strong>References</strong></p> <ol> <li><span style="font-weight: 400;">Jain, R. Chang, WW. Emergency