Cerebrospinal Fluid Analysis – Part 4 – CSF findings In Various Diseases (D/D)
- Cerebrospinal fluid is diagnostic of various diseases. The following table gives a brief summary.
Clinical conditions |
Appearance |
Cell count |
Total proteins |
Other tests |
Cryptococcal meningitis | Clear or turbid | 50 to 150 polys or lymphocytes | 25 to 200 mg/dL | the positive India ink test, and cryptococcal antigen |
Leptospiral meningitis | Clear to slightly hazy | 5 to 100 lymphocytes | 50 to 100 mg/dL | H/O visit a tropical country, contact with animal urine |
Poliomyelitis | Clear or colorless | cells up to 500 lymphocytes | 10 to 300 mg/dL | positive PCR for poliovirus in CSF |
Encephalitis | Clear or slightly hazy | cells up to 500 lymphocytes | 15 to 100 mg/dL | Normal glucose |
Brain tumors | usually clear | 0 to 8 lymphocytes | 15 to 200 mg/dL | positive for malignant cells |
Cerebral hemorrhage | Colorless or yellow or bloody | whole blood cells | 30 to 150 mg/dL | bloody color CSF, and may see increased polys |
Spinal cord tumors | Clear or colorless or yellow | Cells are variable | 1000 to 2000 mg/dl | may be positive for tumors |
Neurosyphilis | Clear and colorless | 10 to 100 lymphocytes | 50 to 150 mg/dL | reactive VDRL, positive CSF T.pallidum antibody |
Tuberculous meningitis | Colorless or yellow with fibrin clot | 50 to 500 lymphocytes | 50 to 300 mg /dL (may reach 1000 mg) | Smear may be positive for AFB stain/ TB culture |
Bacterial meningitis | Cloudy | WBC > 1000 /µL | Increased | Gram stain may show bacteria |
Brain abscess | Clear or turbid | Cells are variable | 20 to 120 mg/dL | Gram stain may help |
Multiple sclerosis | Clear, colorless | 0 to 10 lymphocytes | 50 to 150 mg/dL | IgG index is elevated, positive oligoclonal band |