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The CSF/serum glucose ratio, also known as CSF/blood glucose ratio, is a measurement used to compare CSF glucose and blood sugar. Because many bacteria metabolize glucose, and because the blood–brain barrier minimizes transversal, the ratio can be useful in determining whether there is a bacterial infection in the CSF. The normal ratio is 0.6 ...
CSF glucose levels can be useful in distinguishing among causes of meningitis as more than 50% of patients with bacterial meningitis have decreased CSF glucose levels while patients with viral meningitis usually have normal CSF glucose levels. Decrease in glucose levels during a CNS infection is caused due to glycolysis by both white cells and ...
A closely related test, CSF total protein is a measurement used to determine the levels of protein in cerebrospinal fluid. [2] [3] It combines the albumin, IgG, and other proteins. It can be useful in distinguishing among causes of Meningitis. It is more likely to be elevated in bacterial meningitis than in viral meningitis.
In bacterial meningitis it is typically lower; the CSF glucose level is therefore divided by the blood glucose (CSF glucose to serum glucose ratio). A ratio ≤0.4 is indicative of bacterial meningitis; [52] in the newborn, glucose levels in CSF are normally higher, and a ratio below 0.6 (60%) is therefore considered abnormal. [8]
A small amount of cerebrospinal fluid (CSF) is sent to the laboratory as soon as possible for analysis. The diagnosis is suspected, when Gram-negative diplococci are seen on Gram stain of a centrifuged sample of CSF; sometimes they are located inside white blood cells. The microscopic identification takes around 1–2 hours after specimen ...
When combined with analysis of the appearance and pressure of the tested CSF, along with measurements for the amount of glucose and proteins present, white blood cell counts can be used to detect or diagnose a number of diseases. Among these are subarachnoid hemorrhage, multiple sclerosis, and the various types of meningitis. While a lumbar ...
type 3, oligoclonal bands in CSF and serum with additional bands in CSF; type 4, identical oligoclonal bands in CSF and serum, type 5, monoclonal bands in CSF and serum, type 6, presence of a single band limited to the CSF. Type 2 and 3 indicate intrathecal synthesis, and the rest are considered as negative results (No MS).
The initial test is usually a lumbar puncture to collect cerebrospinal fluid for analysis. The lumbar puncture in chronic meningitis usually shows a lymphocytic predominant inflammatory pattern, however, some infectious agents such as early tuberculosis meningitis, nocardia or brucella may have an neutrophilic predominant inflammation. [2]