Profile of Cerebrospinal Fluid Analysis in Acute Central Nervous System Infections
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 1
Abstract
Background: Confirmatory diagnosis of acute central nervous system (CNS) infection is a concern. Most often, it is presumed and empirical antimicrobials given. CSF findings may overlap in various infections and partially treated meningitis further complicates the CSF analysis. Materials and Methods: This study included 90 patients with acute CNS infection admitted between July 2009 and August 2011. Ninety cases of community-acquired CNS infection were included in the study. The diagnosis of CNS infection was made based on the clinical features. Laboratory investigations such as complete blood count, random blood sugar, urine analysis, renal and liver function tests, and serum electrolytes were done in all cases. Cerebrospinal fluid (CSF) samples were collected and sent for cell count, glucose, protein, chloride, Gram stain, bacterial culture, AFB smear, culture of AFB, and viral markers like herpes simplex virus (HSV). Results: 15 patients (16.7%) had bacterial meningitis, 32 (35.5%) had tuberculous (TB) meningitis, 9 (10%) had aseptic meningitis, 30 (33.3%) had encephalitis, and 4 (4.5%) had cryptococcal meningitis. The CSF sugar-to-blood sugar ratio was found to be <0.5 in 71.1% of all CNS infections. 93.3% of bacterial meningitis, 100% of TB meningitis, and 100% of cryptococcal meningitis had a CSF-to-blood sugar ratio <0.5 while only 33.3% of aseptic meningitis and 40% of encephalitis had such a value. TB meningitis had the maximum mean CSF protein of 275 followed by cryptococcal meningitis - 169. The mean CSF total count was found to be 257 for all CNS infections together. It was found to be maximum 559 for bacterial meningitis. Gram-positive cocci were reported in five patients and Gram-negative coccobacilli were reported in one patient. Polymerase chain reaction (PCR) for TB was positive in 10 (31.2%) patients with TB meningitis. PCR for HSV was positive in 8 (20.5%) patients with aseptic meningitis or encephalitis. IgM HSV was positive in 16 (41%) patients with aseptic meningitis or encephalitis. Conclusion: Routine CSF cell count and biochemical analysis are of prime importance in differentiating between CNS infections and identifying individual CNS infections. PCR was not found to be useful in the diagnosis.
Authors and Affiliations
K Vasanthan, Yeldho Verghese, R B Sudagar Singh, J Damodharan
Keywords
Related Articles
- EP ID EP478524
- DOI -
- Views 150
- Downloads 0
Bacterial Agents and their Antibiotic Resistance Pattern in Neonatal Blood Cultures - A Hospital Based Study
Introduction: Bacterial infections are an important cause of neonatal mortality and morbidity worldwide. Despite advances in neonatal care, antibiotic resistance among common pathogens and the emergence of multidrug-resi...
Influence of Pre-operative Cognitive Status on Propofol Requirement to Maintain Hypnosis in the Elderly: A Study of 50 Cases
Introduction: In elderly patients decrease in cognitive function after anesthesia has been reported in the literature for over a century. Various studies have implicated agents such as propofol and sevoflurane in the dev...
A Comparative Study of Feto-maternal Outcomes in Pre-labor Rupture of Membrane at Term
Aims and Objectives: To compare feto-maternal outcomes in patients with pre-labor rupture of membrane (PROM) at term with that of patients without PROM and also compare the efficacy of three different modes of induction....
Comparative Evaluation of Intravenous Dexmedetomidine and Sublingual Nitroglycerin Spray to Attenuate Hemodynamic Response to Laryngoscopy and Intubation
Introduction: Laryngoscopy and intubation produce hemodynamic response due to increase in sympathetic and sympathoadrenal activity which manifest as increase in blood pressure and heart rate (HR). Objective: This study w...
Prevalence of Complete and Partial Edentulism in the Patients Visiting District Hospital of Kathua, Jammu, Jammu and Kashmir
Aim: The aim of the study was to evaluate the prevalence of complete and partial edentulism in the population of Kathua District, Jammu, Jammu and Kashmir visiting the OPD of District Hospital, Kathua. Materials and Meth...