Cerebrospinal fluid (CSF) analysis – Meningitis

Normal values (CSF):

CSF opening pressure: 50–180 mmH2O
Glucose: 40–85 mg/dL.
Protein (total): 15–45 mg/dL.
Lactate dehyrogenase: 1/10 of serum level.
Lactate: less than 35 mg/dL.
Leukocytes (WBC): 0–5/µL (adults / children); up to 30/µL (newborns).
Gram stain: negative.
Culture: sterile.
Specific gravity: 1.006–1.009.
Syphilis serology: negative.
Gross appearance: Normal CSF is clear and colorless.
Differential: 60–70% lymphocytes; up to 30% monocytes
and macrophages; other cells 2% or less.

Bacterial Meningitis

Glucose (mg/dL): Normal to marked decrease.  <40 mg/dL.
Protein (mg/dL) (Marked increase)  > 250 mg/dL.
WBCs (cells/µL) >500 (usually > 1000).  Early: May be < 100.
Cell differential: Predominance of Neutrophils (PMNs)
Culture: Positive
Opening Pressure Elevated

Fungal Meningitis

Glucose (mg/dL): <40 mg/dL (Low)
Protein (mg/dL) (moderate to marked increase) 25 -500 mg/dL
WBCs (cells/µL) Variable (10 -1000 cells/µL) <500cells/µL.
Cell differential: Predominance of Lymphocytes
Culture: Positive (fungal)
Opening Pressure Variable

Tubercular Meningitis

Glucose (mg/dL): <40 mg/dL (Low)
Protein (mg/dL) (moderate to marked increase) 50 -500 mg/dL
WBCs (cells/µL) Variable (10 -1000 cells/µL) <500cells/µL.
Cell differential: Predominance of Lymphocytes
Culture: Positive for AFB
Opening Pressure Variable

Viral Meningitis

Glucose (mg/dL): Normal   (> 40 mg/dL.)
Protein (mg/dL) <100 mg/dL (moderate increase)
WBCs (cells/µL) < 100 cells/µL.
Cell differential: Early: neutrophils. Late: lymphocytes.
Culture: Negative
Opening Pressure Usually normal

Important Notes

>Unless noted, all values are for adults.

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user’s use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. Read the disclaimer