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This fluid, which normally surrounds the brain and spinal cord, is then analyzed for signs of infection. [22] CSF findings that suggest a viral cause of meningitis include an elevated white blood cell count (usually 10-100 cells/μL) with a lymphocytic predominance in combination with a normal glucose level. [23]
A viral infection can directly cause encephalitis or trigger a cascade ending in autoimmunity, with both mechanisms eventually leading to a rise in CSF lymphocyte concentration. [ citation needed ] For patients with Herpes simplex virus , more than 90% are found to have lymphocytic pleocytosis of varying levels. [ 5 ]
The CSF sample is examined for presence and types of white blood cells, red blood cells, protein content and glucose level. [8] Gram staining of the sample may demonstrate bacteria in bacterial meningitis, but absence of bacteria does not exclude bacterial meningitis as they are only seen in 60% of cases; this figure is reduced by a further 20% ...
The colony stimulating factor 1 (CSF1), also known as macrophage colony-stimulating factor (M-CSF), is a secreted cytokine which causes hematopoietic stem cells to differentiate into macrophages or other related cell types. Eukaryotic cells also produce M-CSF in order to combat intercellular viral infection.
Production of CSF-1 by brain tumors called glioblastomas causes microglia (brain-resident macrophages) to exhibit immunosuppressive, tumor-permissive phenotypes. [16] CSF1R inhibition in mouse glioblastoma models is beneficial and improves survival by inhibiting tumor-promoting functions of microglia.
A CSF fungal culture can tell if there is microbiological failure (failure of the fungal infections to treat the infection). CSF fungal culture has a 90% sensitivity and 100% specificity for the diagnosis of cryptococcal meningitis. CSF cell analysis is characterized by increased lymphocytes, reduced protein and reduced glucose. [17]
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 ...
An analysis of 17 studies published over the past 30 years regarding children with CSF shunt infections revealed that treating with both shunt removal and antibiotics successfully treated 88% of 244 infections, while antibiotic therapy alone successfully treated the CSF shunt infection in only 33% of 230 infections. [28] [32]