A 43-year-old Asian man presents with headache and neck stiffness. CT brain is normal and a lumbar puncture is performed with the following results
Serum glucose: 4.7 mmol/l
Lumbar puncture reveals:
Opening pressure: 15 cmCSF
Appearance: Cloudy
Glucose: 3.3 mmol/l
Protein: 0.7 g/l
White cells: 100 / mm3 (70% lymphocytes)
What is the most likely diagnosis?
A. Bacterial meningitis.
B. Viral meningitis.
C. Tuberculous meningitis.
D. Normal CSF result.
E. Cryptococcal meningitis.
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The CSF lymphocytosis combined with a glucose greater than half the serum level points towards a viral meningitis. TB meningitis is associated with a low CSF glucose
Meningitis: CSF analysis
Bacterial
Appearance Cloudy
Glucose Low (< 1/2 plasma)
Protein High (> 1 g/l)
White cells 10 - 5,000 polymorphs/mm³
Viral
Appearance Clear/cloudy
Glucose Normal*
Protein Normal/raised
White cells 15 - 1,000 lymphocytes/mm³
Tuberculous
Appearance Fibrin web
Glucose Low (< 1/2 plasma)
Protein High (> 1 g/l)
White cells 10 - 1,000 lymphocytes/mm³
*mumps is unusual in being associated with a low glucose level in a proportion of cases. A low glucose may also be seen in herpes encephalitis
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salmak.z. wrote:hello all members. i`m new here so excuse me for any mistakes.
i` wana know where can i send new q?? as a replay or how is it done
thax.
