Chart-17

A 10 year-old-male child presented with fever, severe headache and vomiting.

O/E: Neck rigidity present

CSF analysis:

Appearance     - Clear                   

Proteins           - 45 mg/dl (normal: 20-40 mg/dl)                       

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

Cell count         - 50 cells/cumm

CSF SMEAR: 

A. Identify the predominant cell type.

Lymphocyte

B. What is the diagnosis? Write two points in favour of your diagnosis.

Diagnosis : Viral meningitis

1. Proteins slightly elevated, glucose normal, cell count increased

2. Predominant cell type is lymphocyte

C. List any four indications for lumbar puncture.

Meningitis

Suspected Subarachnoid hemorrhage

Demyelinating diseases

Spinal anesthesia

Intrathecal administration of chemotherapy

Intrathecal administration of antibiotics

Injection of contrast media for myelography or for cisternography

D. Mention two causes of high proteins in CSF?

Tubercular meningitis

Pyogenic meningitis

Cerebral syphilis

Guillain Barre Syndrome