CSF WBC Research Articles

'Doctor's Orders'

CSF Analyses Time of Lumbar Puncture Opening Pressure, mm HO CSF Glucose, mg/dL CSF Protein, mg/dL CSF WBC Count, Cells/cu mm CSF Neutrophils, % CSF Mononuclear Cells, % Admission 210 71 300 5,000 50 50 monocytes 8 hr after admission 210 168 600 62 11 monocytes 27 lymphocytes 4 days after admission 75 67 27 10 90 lymphocytes 6 days after admission 70 54 100 lymphocytes To the Editor. —Ethical attitudes about and toward medical care have changed. Those most concerned can scarcely keep abreast of the relevant publications and seminars. A myriad of scientific and social developments have converged in such a manner that patients, health-care providers, scientists, government personnel, philosophers, ethicists, social workers, private foundations, and politicians provide sources of ideas about what may be wrong ethically and what should be changed in patient care. There is little question that biomedical ethical attitudes must be reanalyzed very critically. One of

Cerebrospinal fluid data. 1. Interpretation in intracranial hemorrhage and meningitis.

In substantiating a diagnosis of intracranial hemorrhage, the most important laboratory findings are RBCs, free hemoglobin, or hemoglobin breakdown products in the CSF. When the Gram stain is negative and results of bacterial, viral, and fungal cultures are pending. CSF WBC and differential counts and glucose and lactic acid levels may provide clues to the cause of meningitis. In addition, counterimmuno-electrophoresis and other immunologic techniques that facilitate the diagnosis of meningitis are now becoming more widely available.

Cerebrospinal fluid evaluation in neonates: comparison of high-risk infants with and without meningitis.

Results of CSF examinations from 117 high-risk neonates were reviewed. The mean CSF cell count was 8.4 cells/mm3 and the range was 0 to 32 cells/mm.3 Approximately 60% of the CSF WBC were polymorphonuclear leukocytes. Average CSF protein concentrations were 90 mg/dl (range, 20-170 mg/dl) in term and 115 mg/dl (range, 65-150 mg/dl) in preterm infants. The average CSF glucose was 81% of the blood glucose value in term and 74% in preterm infants. Comparison of these CSF findings with those from 119 infants with bacterial meningitis revealed that there was considerable overlapping of values, but only one of the 119 infants with meningitis had a completely normal initial CSF examination. The decision to initiate antimicrobial therapy in neonates with suspected meningitis must be based on total evaluation of the patient.