A 44 year old female with a severe headache is seen in the Emergency department. She has no prior history of headaches. She has some neck stiffness and prefers the darkened room.
Vital signs:
T 37.3
PR 90/min
BP 130/80
An LP is performed, which shows:Macroscopic appearance: Turbid
Cell count
Leucocytes 855/ul
Polymorphs 1%
Lymphocytes 99%
Erythrocytes 45%
Biochemistry
Protein 0.63 g/l (0.14-0.45)
Glucose 3.9 mmol/l (2.8-4.4)
Microscopy No bacteria seen
Culture No growth
A culture is continuing
Sample WCC RCC
1 750 290
2 837 72
3 855 45
List 3 possible differentials and your most likely cause
Describe the 4 key abnormalities to help narrow your differential
What other tests would you request to aid in your management?