6 month old Infant with Fever, Anorexia and Vomiting
CSF Shows
WBC 40 80% polys, 20% lymph
RBC 4000
Glucose 55
Protein 45
What is your interpretation?
Thanks! Of course I have my own ideas, but I was hoping to see what everyone here thought first. This is for an oral exam coming up in a few days.
Thanks
Maybe viral meningitis/encephalitis + bloody tap
Opening pressure? Gram stain? Color? Hopefully bacterial cultures are pending and you have other lab results (like a CBC). Duration of Sx? Season of the year/location when this kid presented? Where is this kid on the growth curve? FH? SH? Travel Hx? Exposures?
From NIH: "Increased white blood cells in the CSF may be a sign of meningitis, acute infection, beginning of a chronic illness, tumor, abscess,stroke, or demyelinating disease.... Red blood cells in the CSF sample may be a sign of bleeding into the spinal fluid or the result of a traumatic lumbar puncture.
For the DDx you could probably could come up with a couple of things for each in the following list:
V - Vascular (vascular malformations, coagulopathies...)
I - Infection/Inflammatory/Auto-Immune (bacterial, viral, fungal, parasites..)
N - Neoplasm (Primary or Metastatic)
D - Drugs
I - Iatrogenic
C - Congenital/Developmental/Inherited (immunologic d/o)
A - Anatomic
T - Trauma
E - Environmental Exposure/Endocrine/Metabolic
