Cerebrospinal Fluid Analysis:- Part 4 – CSF findings In Various Diseases (Differential/Diagnosis)
- Cerebrospinal fluid analysis is diagnostic of various diseases. Various diseases of the central nervous system can be diagnosed by the examination of CSF.
- The following table gives a brief summary.
|Cryptococcal meningitis||Clear or turbid||50 to 150 polys or lymphocytes||25 to 200 mg/dL||The positive India ink test, and cryptococcal antigen|
|Leptospiral meningitis||Clear to slightly hazy||5 to 100 lymphocytes||50 to 100 mg/dL||H/O visit a tropical country, contact with animal urine|
|Poliomyelitis||Clear or colorless||cells up to 500 lymphocytes||10 to 300 mg/dL||Positive PCR for poliovirus in CSF|
|Encephalitis||Clear or slightly hazy||cells up to 500 lymphocytes||15 to 100 mg/dL||Normal glucose|
|Brain tumors||usually clear||0 to 8 lymphocytes||15 to 200 mg/dL||Positive for malignant cells|
|Cerebral hemorrhage||Colorless or yellow or bloody||whole blood cells||30 to 150 mg/dL||Bloody color CSF, and may see increased polys|
|Spinal cord tumors||Clear or colorless or yellow||Cells are variable||1000 to 2000 mg/dl||It may be positive for tumors|
|Neurosyphilis||Clear and colorless||10 to 100 lymphocytes||50 to 150 mg/dL||Reactive VDRL, positive CSF T.pallidum antibody|
|Tuberculous meningitis||Colorless or yellow with fibrin clot||50 to 500 lymphocytes||50 to 300 mg /dL (may reach 1000 mg)||Smear may be positive for AFB stain/ TB culture|
|Bacterial meningitis||Cloudy||WBC > 1000 /µL||Increased||Gram stain may show bacteria|
|Brain abscess||Clear or turbid||Cells are variable||20 to 120 mg/dL||Gram stain may help|
|Multiple sclerosis||Clear, colorless||0 to 10 lymphocytes||50 to 150 mg/dL||IgG index is elevated, positive oligoclonal band|