Pages Below:
| |
Lumbar Puncture
Indications
- suspected menigitis / encephalitis
- suspected subarachnoid haemorrhage
- negative CT
- >6 hours after onset
- suspected inflammatory polyneuropathies
- neurological involvement
- suspected MS
- diagnosis of neurological symptoms in cancer patients
- drug instillation
- CSF removal
- benign intracranial hypertension
Contra-indications
- raised CSF pressure due to focal lesion
- spinal block / cord compression
- anticoagulants / bleeding disorders
- skin infection
Results
| Cause |
Appearance |
Cell count |
Protein |
Glucose |
Microbiology |
| Bacterial meningitis |
cloudy, purulent |
↑ (<10,000), mainly neutrophils |
mildly ↑ |
↓ |
positive Gram stain and culture |
| Bacterial meningitis (partially treated) |
|
↑ (<500) mixed mononuclear / neutrophil |
normal, slightly ↑ |
Normal / ↓ |
Gram stain and culture negative
antigens
PCR |
| Viral Meningitis |
clear, slightly turbid |
↑ occ. normal, mononuclear |
normal / ↑ |
Normal |
Negative cultures
Viral culture or PCR positive |
| Tuberculosis |
clear, slightly turbid |
↑ mononuclear |
↑↑↑ |
↓ |
Positive Ziehl-Nielsen stain
Culture takes 6 week |
|