Dynamic observation of cerebrospinal fluid cytology and specific stain in tuberculous meningitis,purulent meningitis and cryptococcal meningitis

Abstract

Objective To study the clinical value of cerebrospinal fluid cytology(csfc)and specific stain in tuberculous meningitis(TBM)-purulent meningitis(PM)and cryptococcal meningitis(CM).Methods The csfc data of 179 patients with TBM,PM and CM were retrospectively analyzed.The samples collected from all of these patients were analyzed by csfc May-Grunwald-Giemsa(MGG)staining,aricine blue staining and Indian ink staining. And the cytospin smears from 70 TBM were simultaneously stained by the immunofluorescence(IF)and immunocytological method to demonstrate the presence of mycobacterial antigen.Results ①TBM group showed a mixed-cell response.At the early stage of disease,the proportion of neutrophilic granulocyte reached 80%,and then reduced gradually.Lyumphoidocyte reaction was the most obvious in 1～2 months.The immunofluorescence(IF)and immunocytological method present a sensitivity of 82.9%and 85.7%,respectively.②Neutrophilic granulocyte was the most cell at acute stage of PM,and it descended quickly once treated with effective antibiotics.③The positive rates to detect CM with csfc MGG,aricine and Indian ink staining were 83.3%,81.8%,and 76.5%,respectively.Conclusion Dynamic observation on cerebrospinal fluid cytology is helpful to boost the differential diagnosis of intracranial infection. Key words: Tuberculous meningitis; Purulent meningitis; Cryptococcal meningitis; Cytology; Specific stains