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5th August 2024
Interpretation of cerebrospinal fluid results
Correct interpretation of cerebrospinal fluid (CSF) characteristics can indicate the diagnosis before culture results are available and, therefore, guide management decisions.
| CSF appearance | Opening pressure (cmH₂O) | WBC (per mm³) | Protein
(g/litre) |
Glucose
(mmol/Litre) |
|
|---|---|---|---|---|---|
| Normal | Clear | 5-20 | 0-5 (lymphocytes) | 0.2-0.45 | 75% of blood glucose |
| Viral | Clear | normal/↑ | 15-1,000 (lymphocytes) | ↑ | Normal |
| Bacterial | Turbid | ↑ | 100-60,000
(predominantly neutrophils) |
↑ | ↓ |
| TB | Opaque | ↑ | 10-500 (neutrophils initially, then lymphocytes) | ↑ | ↓ |
| Fungal | Clear/cloudy | ↑ | 25-500 (mainly lymphocytes) | ↑ | ↓ |
Image Source: James Heilman, M.D. Own work. CC BY-SA 3.0. Wikimedia Commons (2010). Vasculitis, Licensed under a creative commons licence. Available for free at: https://commons.wikimedia.org/wiki/File:Vasculitis.JPG (Accessed: 16 January 2024)
Image Source: James Heilman, M.D. Own work. CC-BY-SA-4.0. Image Source: Wikimedia Commons (2019). MenigitisCSF2019, Licensed under a creative commons licence. Available for free at: https://commons.wikimedia.org/wiki/File:MenigitisCSF2019.jpg (Accessed: 16 January 2024)
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