Pt was male 40 yrs who came with co headache vomiting irritablity Lp done csf report enclosed interpret finding

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CSF cell count is not very high, it is pointing to Tubercular meningitis, viral meningitis Differential count shows 100% lymphocyte - it is pointing to Tubercular or viral meningitis CSF glucose is low - it is pointing to Tubercular or bacterial meningitis CSF proteins are raised - it is pointing to Tubercular or Bacterial meningitis In all above Tubercular meningitis is common to all - therefore all parameters are pointing to Tubercular meningitis It is very important to start treatment as early as possible in tubercular meningitis as it may land up with severe debilitating complication Suggest CSF for gene Xpert, TB culture, Empirical antitubercular treatment with steroid

Thank you doctor
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Duration of symptom is very important. CSF lymphocytic lukocytosis with elevated protein and very low glucose. NEUROTB is possible. Viral meningitis usually shows normal or elevated sugar. Suggest CSF PCR of M Tuberculosis. Suggest MRI brain with contrst ,emperically start 4 drug ATT regimen with steroids.By the time PCR report will come

Inconclusive may be bacterial or viral meningitis do repeat LP after48 hr then decide

Lymphocyte 100 percent favor tb meningitis
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Csf shows leucocytosis Lymphos are 100% Proteins are raised with raised LDH Bacterial meningitis

DD TB meningitis Viral meningitis Suggest CSF test for CBNATT and culture

Repeat CSF glucose with simultaneous blood glucose. Apparently a case of HaNDL syndrome if there were no fever or raised CRP

Viral meningitis

Pandys test positive and TLC range increased... May be associated with Meningitis

Granulomatous Meningitis Carcinomatous Meningitis

High protein,low glucose,only lymphocytes,pointers towards a tubercular aetiology.

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