Question
List, in tabular form, the CSF parameters, in normal CSF and in pyogenic, viral and tubercular meningitis.
Q114 marksShort Answers
Answer
CSF parameters — normal versus meningitis types
| Parameter | Normal | Pyogenic (bacterial) meningitis | Viral meningitis | Tubercular meningitis |
|---|
| Appearance | Clear, colourless | Turbid/purulent | Clear/slightly turbid | Clear, may form a fine “cobweb” clot on standing |
| Opening pressure | Normal (5–20 cm H₂O) | Markedly raised | Normal/mildly raised | Raised |
| Cell count | 0–5 cells/μL (lymphocytes) | Markedly raised (100s–1000s/μL) | Moderately raised (10s–100s/μL) | Moderately raised (100s/μL) |
| Predominant cell type | Lymphocytes | Neutrophils | Lymphocytes | Lymphocytes (though early disease may show neutrophil predominance) |
| Protein | 15–45 mg/dL | Markedly elevated (>100 mg/dL) | Mildly-moderately elevated | Markedly elevated (100–500 mg/dL) |
| Glucose | 50–80 mg/dL (or ~2/3 of blood glucose) | Markedly reduced (<40 mg/dL) | Normal | Reduced (though usually not as low as pyogenic) |
| CSF:blood glucose ratio | ~0.6 | <0.4 | Normal (~0.6) | Reduced (<0.5) |
| Gram stain/AFB stain | Negative | Positive (organism-specific morphology) | Negative | Acid-fast bacilli may be seen (often low sensitivity) |
| Culture | Sterile | Positive (bacterial culture) | Sterile (or viral culture/PCR positive) | Positive on mycobacterial culture (slow) |
- 1Pyogenic (Bacterial) Meningitis
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