ROLE OF CEREBROSPINALFLUID IN THE DIAGNOSIS OFMENINGITISIHSAN ALITRAINEE TECHNOLOGISTAKUH
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.
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
Causes of Meningitis-Bacterial Infections-Viral Infections-Fungal Infections)Crypto co ccus ne o fo rm ansCo ccidio de s im m itus(
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
Viral MeningitisEtiological Agents:Enteroviruses (Coxsackies and echovirus): most common.-Adenovirus-Arbovirus-Measles virus-Herpes Simplex Virus-Varicella
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.
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.
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.
GlucoseThe normal Glucose is about 60% compared to serumlevel.Normal 50~80mg/dlViral meningitis > 50% of serum levelDecreased GlucoseBacterial Meningitis(very low(
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(
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
White Blood cells in CSF>5White Blood cellsIncreased in Bacterial Meningitis (Neutrophills(Increased in Viral Meningitis (lymphocytes(Increased in Tuberculosis Meningitis(Neutrophills , Lymphocytes(
Culture of CSFCSF Contains few organisms so concentration isrequiredCentrifuge at 10000rpm for 10 minsSediments is used for culturesMedia UsedChocolate AgarMacconkey AgarBlood Agar
LATEX PARTICALAGGLUTINATION TEST (LPA(ANTIGEN & ANTIBODY REACTIONKeep CSF for 5 mins in boiling waterExposure of AntigenTreated with anti-seraAgglutination PositiveFor Bacteria.