csf findings: Elevated pressure , turbid. Elevated cell count >1000/mm3 , mostly polymorphic neutrophil. Protiens are elevated above 100mg/dl. Sugar is reduced below 50% of blood sugar level or below 40mg /dl. Microspic examination of sediments with gram stain helps to identify organisms. Collect CSF for culture. In partially treated cases CSF is clear with more lymphocytes, culture is usually sterile.

1. INVESTIGATIONS OF ACUTE
BACTERIAL MENINGITIS
-M.SANTHOSH KUMAR

2. EXAMINATION OF CSF
Perform LP without prior neuroimaging in:
a. Immunocompetent patient
b. No h/o recent head trauma
c. Normal level of consciousness
d. No evidence of papilledema / focal neurological deficit

3. CSF ABNORMALITIES
• Elevated pressure , turbid.
• Elevated cell count >1000/mm3 , mostly polymorphic neutrophil.
• Protiens are elevated above 100mg/dl.
• Sugar is reduced below 50% of blood sugar level or below 40mg /dl.
• Microspic examination of sediments with gram stain helps to identify
organisms.
• Collect CSF for culture.
• In partially treated cases CSF is clear with more lymphocytes, culture
is usually sterile.

4. NEUROIMAGING
• CT is not necessary for diagnosis but useful to exclude subdural
effusion, brain abcess, hydrocephalus and vascular complications.
• Used to differentiate between partially treated pyogenic meningitis
and tubercular meningitis.

6. RAPID DIAGNOSTIC TEST
• Used to distinguish between bacterial , viral and tubercular meningitis
based on antigen or antibody demonstration.
• Methods include :
a. Countercurrent immunoelectrophoresis.
b. Latex partical agglutination.
c. ELISA.
• They are unaltered by use of antibiotics.

7. THANK YOU