Lab Case 91 – Interpretation

A 29 year old female with features of meningitis

1.

Protein high, suggests bacterial infection

Glucose < 40% of BSL

Predominance of RCC with some WCC (mainly lymphocytes)

Mixed picture without definitive diagnosis requiring empiric treatment and further investigation/ testing

2.

Bacterial meningitis

Partially treated meningitis

Viral meningitis

Subarachnoid Haemorrhage

Other – GBS, MS, TB, Fungal

3.

NormalBacterialViralFungalTBSubarachnoid
Haemorrhage
AppearanceClearClear, cloudy, purulentClearClear, cloudyclear, opaqueBloody, clear, Xanthochromia
Opening
Pressure
10-2025N or highElevatedElevatedElevated
WCC0-5>10010-100010-50050-500WCC:RCC 1:1000
Differential<2 PMN>90% PMNPMN early but Lymphocytes>PMNanyEarly PMN, Lymphocytes>PMNRCC predominates
Glucose>60% BSL<40% BSL>60% BSLLowLowNormal
Protein<0.5>0.5>0.5ElevatedElevatedElevated
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