Apr 28, 2020
Contributor: Eric Miller, MD
cell count is performed on tubes 1 and 4 to account for changes
that may occur from blood entering the first sample from the needle
2 and 3 are usually used for the other studies like protein levels,
glucose levels and gram staining
- Protein levels are often elevated in bacterial
meningitis but can be helpful in diagnosis conditions like multiple
- Glucose levels are typically low in bacterial
meningitis due to the use of glucose by bacteria
counts above 3-5 cells are typically abnormal, but cell counts can
vary widely depending on the type of meningitis (viral vs.
bacterial) and how long the infection has been present.
type and differential can indicate viral vs. bacterial
- Neutrophils are more associated with bacterial
- Lymphocytes are more associated with viral
cultures are used to identify the cause of bacterial meningitis but
can take days to result.
gram stain can help determine if any bacteria are present as well
as cell types present.
- Jain, R. Chang, WW. Emergency
Department Approach to the Patient with Suspected Central Nervous
System Infection. Emerg Med Clin North Am. 2018 Nov;36(4):711-722.
Summarized by Jackson Roos,
MS3 | Edited by Erik Verzemnieks, MD