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Medicine

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Neurology

Question
8 out of 18
 

True about CSF finding in TB meningitis is: (LQ)



A CSF contains no organisms

B Chloride, Glucose

C Glucose, protein

D Chloride, glucose

Ans. B

. Chloride, Glucose

INVESITIGATION –

CSF analysis (AIPG 2007)

Conditions

Appearance

Cells /ml

Glucose

Protein

Normal

Clear

0 – 5

2/3 of Plasma

15 – 45mg%

Pyogenic

Turbid

Highly raised mainly PMN

ighly reduced

1 – 2g%

T.B.

Fibrin web

Raised mainly Lympho

Reduced

2 – 5 g%

Aseptic (viral)

Clear

50 – 1500

Normal

Normal/increase

Malignancy

Clear

Lympho

Decrease

Normal/ increase

Extra edge:CSF abnormalities in bacterial meningitis. (Ref. Hari-18th ed., pg- 3414)

1). Opening pressure = >180 mmH2O

2). CSF / serum glucose = <0.4

3). Latex agglutination = May be positive in patients with meningitis due to S. pneumoniae,

4). Limulus lysate = Positive in cases of gram-negative meningitis

5). PCR = Detects bacterial DNA

6). Gram's stain = Positive in >60%

7). Culture = Positive in >80%

Extra Edge:

Elevated CSF protein and decreased sugar and chloride levels along with characteristic clinical features of meningitis suggest a diagnosis of Tubercular meningitis.

Typical CSF features of Tubercular Meningitis are:

1). Cells: Mononuclear cells (except early infection when PMN cells are seen)

2). Protein: Increased above 40 mg/100ml.

3). Sugar: Usually reduced to less than 2/3rd of blood sugar.

4). Chloride level: usually reduced.

Important points about TBM:

1). In TBM, the exudate is mainly basal (basal brain is involved)

2). Subarachnoid space is involved-by the exudate (i.e. subarachnoiditis is present)

3). Involvement is mainly of the Leptomeninges i.e. Pia-arachnoid. (Duramater is usually spared.)

Neurology Flashcard List

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