Document Detail


Cerebrospinal fluid analysis.
MedLine Citation:
PMID:  14524396     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Lumbar puncture is frequently performed in primary care. Properly interpreted tests can make cerebrospinal fluid (CSF) a key tool in the diagnosis of a variety of diseases. Proper evaluation of CSF depends on knowing which tests to order, normal ranges for the patient's age, and the test's limitations. Protein level, opening pressure, and CSF-to-serum glucose ratio vary with age. Xanthochromia is most often caused by the presence of blood, but several other conditions should be considered. The presence of blood can be a reliable predictor of subarachnoid hemorrhage but takes several hours to develop. The three-tube method, commonly used to rule out a central nervous system hemorrhage after a "traumatic tap," is not completely reliable. Red blood cells in CSF caused by a traumatic tap or a subarachnoid hemorrhage artificially increase the white blood cell count and protein level, thereby confounding the diagnosis. Diagnostic uncertainty can be decreased by using accepted corrective formulas. White blood cell differential may be misleading early in the course of meningitis, because more than 10 percent of cases with bacterial infection will have an initial lymphocytic predominance and viral meningitis may initially be dominated by neutrophils. Culture is the gold standard for determining the causative organism in meningitis. However, polymerase chain reaction is much faster and more sensitive in some circumstances. Latex agglutination, with high sensitivity but low specificity, may have a role in managing partially treated meningitis. To prove herpetic, cryptococcal, or tubercular infection, special staining techniques or collection methods may be required.
Authors:
Dean A Seehusen; Mark M Reeves; Demitri A Fomin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American family physician     Volume:  68     ISSN:  0002-838X     ISO Abbreviation:  Am Fam Physician     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-10-03     Completed Date:  2003-10-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1272646     Medline TA:  Am Fam Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1103-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Family Practice and Emergency Medical Services, Tripler Army Medical Center, Honolulu, Hawaii, USA. dseehusen@msn.com
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MeSH Terms
Descriptor/Qualifier:
Cell Count
Central Nervous System Diseases / diagnosis*
Cerebrospinal Fluid / chemistry*
Cerebrospinal Fluid Proteins / analysis
Humans
Leukocyte Count
Meningitis / cerebrospinal fluid,  diagnosis
Chemical
Reg. No./Substance:
0/Cerebrospinal Fluid Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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