Laboratory Diagnosis of Meningitis

Abstract

Tuberculous meningitis (TBM), is common in those from countries where tuberculosis is common, and is also encountered in those with immune problems, such as AIDS. Despite advancement in vaccine development and chemoprophylaxis bacterial meningitis remains a major cause of death and neurological disabilities which can be prevented by rapid and accurate diagnosis with prompt treatment which is essential for good outcome (Carbonnelle, 2009). Viral meningitis is generally less severe and clears up without specific treatment. Viral ("aseptic") meningitis is serious but rarely fatal in people with normal immune systems. Usually, the symptoms last from 7 to 10 days and the patient recovers completely. Often, in www.intechopen.com Please use Adobe Acrobat Reader to read this book chapter for free. Just open this same document with Adobe Reader. If you do not have it, you can download it here. You can freely access the chapter at the Web Viewer here. Meningitis 186 early phases of viral meningitis and bacterial meningitis, the symptoms are almost similar (Carbonnelle, 2009). Fungal meningitis is rare, but can be life threatening. Although anyone can get fungal meningitis, people at higher risk are those who have AIDS, leukemia, or other forms of immunodeficiency. The most common cause of fungal meningitis in HIV, is Cryptococcus spp. In the last two decades, more elaborative use of intensive care units for serious medical disorders, advancements in transplant procedures and concomitant use of immunosuppressive therapies as well as the pandemic spread of HIV, etc. have increased the incidence of Central Nervous System (CNS) fungal infections which present with various clinical syndromes: meningitis commonly. The clinical picture may mimic TBM and therefore, needs careful evaluation. The CNS mycoses carry higher risks of morbidity and mortality as compared to other infective processes and therefore promptly require precise diagnosis and appropriate medical and/or surgical management strategies to optimize the outcome (Raman Sharma, 2010). Chemical meningitis can develop after neurosurgical procedures and can be differentiated from bacterial meningitis by Cerebrospinal fluid (CSF) glucose levels and CSF White Blood Cell (WBC) values. The causes of non-infectious meningitis include cancers, systemic lupus erythematosus, drug induced, head trauma, brain surgery etc. Please use Adobe Acrobat Reader to read this book chapter for free. Just open this same document with Adobe Reader. If you do not have it, you can download it here. You can freely access the chapter at the Web Viewer here.

Frequency of Bacterial Organisms Isolated from Cerebrospinal Fluid (CSF) of Children under Five Years in Windhoek from 2010 to 2014

“…Bacterial meningitis leads to a predominance of neutrophils in CSF in about 80% -95% of bacterial meningitis cases [11]. The findings of this current study however indicated that only 21.3% of all culture positive cases had a neutrophil count greater than 5/mm 3 as shown in Table 5, which is regarded as a significant cut off value in the normal range of CSF neutrophil count [8].…”

“…Gram stain yields positive results in 10% -15% of patients with bacterial meningitis, who test negative with culture results [11]. The current study found that Gram stain was only positive in 0.7% of the culture negative cases.…”

“…Although bacterial culture is regarded as a gold standard in the diagnosis of meningitis, the use of antibiotics prior to collection of CSF might attribute to false negative culture results, which therefore necessitates the use of non-culture techniques such as PCR for diagnosis. PCR is the most accurate and reliable method among the non-culture techniques and it is a highly sensitive and specific method which detects specific bacterial DNA in CSF [11].…”

“…Laboratory findings of reduced CSF glucose in relation to plasma glucose signify the presence of bacteria in CSF, which metabolises CSF glucose [11]. CSF glucose results alone cannot be used in making decisions pertaining to presence or absence of bacteria in CSF, without comparison with plasma glucose, although it potentially indicates the possibility of bacterial meningitis.…”

Meningoencefalitis por Herpes simplex virus 1 y Streptococcus pneumoniae en Pediatría. Reporte de caso

“…Los hallazgos identificados en el citoquímico de la PL como pleocitosis, con predominio de neutrófilos, hipoglucorraquia, e hiperproteinorraquia en conjunto con la identificación de la coloración Gram, fueron compatibles con meningitis bacteriana, con características plenas descritas en la literatura 13 . Se ha visto que en meningitis bacteriana los hemocultivos pueden identificar el Streptococcus pneumoniae en el 75% de los casos, y para el cultivo de LCR hasta en el 87% 13 . Nuestro paciente tuvo el mismo aislamiento microbiológico en ambos cultivos.…”