CSF
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CSF Presentation Transcript

  • 1. In the name of Allah
  • 2. ROLE OF CEREBROSPINALFLUID IN THE DIAGNOSIS OFMENINGITISIHSAN ALITRAINEE TECHNOLOGISTAKUH
  • 3. What is meningitis?……The brain and spinal cord are covered by connectivetissue layers collectively called the meninges which formthe blood-brain barrier.1-the pia mater (closest to the CNS(2-the arachnoid mater3-the dura mater (farthest from the CNS(.The meninges contain cerebrospinal fluid (CSF).Meningitis is an inflammation of the meninges, which, ifsevere, may become encephalitis, an inflammation ofthe brain.
  • 4. What is Meningitis?Meningitis can be caused by many differentorganisms including viruses and bacteria.Meningitis, caused by a bacteria, is life threateningand requires urgent medical attention and treatmentwith antibiotics.Meningitis caused by a virus is very rarely lifethreatening but can cause the body to become veryweak.When bacteria invade the body they can causemeningitis, septicaemia or meningitis andsepticaemia together
  • 5. Causes of Meningitis-Bacterial Infections-Viral Infections-Fungal Infections)Crypto co ccus ne o fo rm ansCo ccidio de s im m itus(
  • 6. Bacterial meningitis…..Etiological Agents:Pneumococcal, Stre pto co ccus pne um o niae(38 %(Meningococcal, Ne isse ria m e ning itidis (1 4%(Hae m o philus influe nz ae (4%(Staphylococcal, Staphylo co ccus aure us (5%(Tuberculous, Myco bacte rium tube rculo sis
  • 7. Viral MeningitisEtiological Agents:Enteroviruses (Coxsackies and echovirus): most common.-Adenovirus-Arbovirus-Measles virus-Herpes Simplex Virus-Varicella
  • 8. Symptoms of MeningitisMeningitis may not always be easy to detect, inearly stages the symptoms can be similar toflu.  They may develop over one or two days,but sometimes develop in a matter of hours.It is important to remember that symptoms donot appear in any particular order and somemay not appear at all.
  • 9. Symptoms formeningitis::Babies and Young Children-High temperature, fever, possibly with cold hands and feet-Vomiting or refusing feeds-Whimpering cry-Blank, staring expression-Pale, blotchy complexion-Stiff neck-Arched back-Difficult to wake or lethargic-The fontanelle (soft spot on babies heads) may be tense orbulging.
  • 10. OlderChildren and Adults-High temperature, fever, possibly with cold hands andfeet.-Vomiting, sometimes diarrhoea.-Severe headache.-Joint or muscle pains, sometimes stomach cramps.-Neck stiffness (unable to touch the chin to the chest(-Dislike of bright lights.-Drowsiness.The patient may be confused or disorientated. Fitting mayalso be seen.A rash may develop.
  • 11. LUMBER PUNCTURE
  • 12. LUMBER PUNCTURE:
  • 13. CSF NORMAL COMPOSITIONAND PRESSURENormal opening pressure in adults is90~180mmH2O, 10~100mmH2O in children.Colour less>5RBCs>5WBCsProtein 23-38 mg/dlGlucose 60% of serum level(50-80(
  • 14. Elevated pressureAcute Purulent MeningitisTuberculous MeningitisViral MenigitisCerebral edemaMass lesion
  • 15. GlucoseThe normal Glucose is about 60% compared to serumlevel.Normal 50~80mg/dlViral meningitis > 50% of serum levelDecreased GlucoseBacterial Meningitis(very low(
  • 16. ProteinOver 80% of CSF protein content is derived fromthe plasma.An increased CSF protein serves as a useful butnonspecific indicator of disease.Normal level 23~38mg/dl.Elevated in all infectious meningitisMay remains elevated for months postmeningitis (Viral or Bacterial(
  • 17. White Blood cells countTotal WBC,s CountPrepare 1:2 Dilution with Turk solutionCharge on Neubeur ChamberCount in 4 large (WBC,s(squaresDifferential WBC,s CountCentrifuge CSFPrepare slide from DepositStain with Leishman stain
  • 18. White Blood cells in CSF>5White Blood cellsIncreased in Bacterial Meningitis (Neutrophills(Increased in Viral Meningitis (lymphocytes(Increased in Tuberculosis Meningitis(Neutrophills , Lymphocytes(
  • 19. Culture of CSFCSF Contains few organisms so concentration isrequiredCentrifuge at 10000rpm for 10 minsSediments is used for culturesMedia UsedChocolate AgarMacconkey AgarBlood Agar
  • 20. LATEX PARTICALAGGLUTINATION TEST (LPA(ANTIGEN & ANTIBODY REACTIONKeep CSF for 5 mins in boiling waterExposure of AntigenTreated with anti-seraAgglutination PositiveFor Bacteria.
  • 21. Thank You