Chart-16

A young male presented with headache, malaise & vomiting.

O/E: Neck rigidity was noted.

CSF analysis:

Appearance         - Slightly turbid

Proteins              - 140 mg/dl (normal: 20-40 mg/dl)

Glucose              - 30 mg/dl (normal: 45-80 mg/dl)                  

Cell count           - 500 Cells/cumm

CSF SMEAR: 

A.Identify the predominant cell type.

Lymphocytes

B.  What is the diagnosis?  

Tubercular meningitis

C. Write two points in favour of your diagnosis. 

         1. Proteins are markedly increased, glucose reduced, cell count increased.

         2.  Predominant cell type is lymphocyte with a few neutrophils

D. What appears in the CSF when allowed to stand for few hours?

          Cob web formation

E. What is Xanthochromia? What are the causes?

           Yellowish appearance of cerebrospinal fluid is xanthochromia

           Causes –Subarachnoid hemorrhage, Jaundice, increased protein levels in CSF