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Aseptic meningitis is the inflammation of the meninges, a membrane covering the brain and spinal cord, in patients whose cerebral spinal fluid test result is negative with routine bacterial cultures. Aseptic meningitis is caused by viruses , mycobacteria , spirochetes , fungi , medications , and cancer malignancies. [ 1 ]
The CSF/serum glucose ratio, also known as CSF/blood glucose ratio, is a measurement used to compare CSF glucose and blood sugar. Because many bacteria metabolize glucose, and because the blood–brain barrier minimizes transversal, the ratio can be useful in determining whether there is a bacterial infection in the CSF. The normal ratio is 0.6 ...
CSF glucose levels can be useful in distinguishing among causes of meningitis as more than 50% of patients with bacterial meningitis have decreased CSF glucose levels while patients with viral meningitis usually have normal CSF glucose levels. Decrease in glucose levels during a CNS infection is caused due to glycolysis by both white cells and ...
CSF vs serum c-reactive protein and procalcitonin have not been shown to elucidate whether meningitis is bacterial or viral. [ 14 ] In certain cases, a CT scan of the head should be done before a lumbar puncture such as in those with poor immune function or those with increased intracranial pressure . [ 1 ]
There are no specific signs or symptoms that can indicate meningitis, and a lumbar puncture (spinal tap) to examine the cerebrospinal fluid is recommended for diagnosis. [47] Lumbar puncture is contraindicated if there is a mass in the brain (tumor or abscess) or the intracranial pressure (ICP) is elevated, as it may lead to brain herniation.
A viral infection can directly cause encephalitis or trigger a cascade ending in autoimmunity, with both mechanisms eventually leading to a rise in CSF lymphocyte concentration. [citation needed] For patients with Herpes simplex virus, more than 90% are found to have lymphocytic pleocytosis of varying levels. [5]
A closely related test, CSF total protein is a measurement used to determine the levels of protein in cerebrospinal fluid. [2] [3] It combines the albumin, IgG, and other proteins. It can be useful in distinguishing among causes of Meningitis. It is more likely to be elevated in bacterial meningitis than in viral meningitis.
Growth indicated a bacterial meningitis, while no growth indicated another cause denoted "aseptic" meningitis. [1] The most common form of this is viral meningitis. [1] Recent medical advances allows rapid polymerase chain reaction (PCR) testing that analyzes the CSF for DNA or RNA. This can quickly determine if there are bacterial or viral ...