Interpretation of CSF – Hartman

GLUCOSE

< 10 = bacterial, TB, fungal

10-40 = bacterial, viral, syphilis, mumps, LCMV

normal = 2/3 of blood glucose

high CSF glucose corresponds to high blood glucose

low glucose is worrisome!

 

PROTEIN

100-500 = bacterial

50-300 = viral (<160 = enterovirus, > 100 = HSV, >900 = WNV, normal = flu)

high RBCs will cause high protein – correct by subtracting 1 mg/dL per 1000 RBC/mm^3

normal = 18-58 (SMH lab is approx 40)

high protein is worrisome!

 

WBC

greater than 1000 = bacterial

100-1000 = bacterial, viral (400-4000 eastern equine, < 2000 western equine, <200 WNV), TB, encephalitis

<100 = early bacterial, viral (HSV ~100), syphilis, TB, encephalitis

normal = 70% lymphocytes, 30% monocytes – low in Guillain-Barre (<10), high in MS

 

VIRAL SEASONAL PATTERNS

  • summer = enterovirus, amoebae, WNV
  • late summer/fall = arbovirus
  • winter = post-infectious encephalitis if incomplete vaccination
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