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INVESTIGATIONS OF ACUTE
BACTERIAL MENINGITIS
-M.SANTHOSH KUMAR
EXAMINATION OF CSF
Perform LP without prior neuroimaging in:
a. Immunocompetent patient
b. No h/o recent head trauma
c. Normal level of consciousness
d. No evidence of papilledema / focal neurological deficit
CSF ABNORMALITIES
• Elevated pressure , turbid.
• Elevated cell count >1000/mm3 , mostly polymorphic neutrophil.
• Protiens are elevated above 100mg/dl.
• Sugar is reduced below 50% of blood sugar level or below 40mg /dl.
• Microspic examination of sediments with gram stain helps to identify
organisms.
• Collect CSF for culture.
• In partially treated cases CSF is clear with more lymphocytes, culture
is usually sterile.
NEUROIMAGING
• CT is not necessary for diagnosis but useful to exclude subdural
effusion, brain abcess, hydrocephalus and vascular complications.
• Used to differentiate between partially treated pyogenic meningitis
and tubercular meningitis.
RAPID DIAGNOSTIC TEST
• Used to distinguish between bacterial , viral and tubercular meningitis
based on antigen or antibody demonstration.
• Methods include :
a. Countercurrent immunoelectrophoresis.
b. Latex partical agglutination.
c. ELISA.
• They are unaltered by use of antibiotics.
THANK YOU

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Investigations of acute bacterial meningitis

  • 1. INVESTIGATIONS OF ACUTE BACTERIAL MENINGITIS -M.SANTHOSH KUMAR
  • 2. EXAMINATION OF CSF Perform LP without prior neuroimaging in: a. Immunocompetent patient b. No h/o recent head trauma c. Normal level of consciousness d. No evidence of papilledema / focal neurological deficit
  • 3. CSF ABNORMALITIES • Elevated pressure , turbid. • Elevated cell count >1000/mm3 , mostly polymorphic neutrophil. • Protiens are elevated above 100mg/dl. • Sugar is reduced below 50% of blood sugar level or below 40mg /dl. • Microspic examination of sediments with gram stain helps to identify organisms. • Collect CSF for culture. • In partially treated cases CSF is clear with more lymphocytes, culture is usually sterile.
  • 4. NEUROIMAGING • CT is not necessary for diagnosis but useful to exclude subdural effusion, brain abcess, hydrocephalus and vascular complications. • Used to differentiate between partially treated pyogenic meningitis and tubercular meningitis.
  • 5.
  • 6. RAPID DIAGNOSTIC TEST • Used to distinguish between bacterial , viral and tubercular meningitis based on antigen or antibody demonstration. • Methods include : a. Countercurrent immunoelectrophoresis. b. Latex partical agglutination. c. ELISA. • They are unaltered by use of antibiotics.