Laboratory testing on cerebrospinal fluid. A reappraisal.
555 consecutive cases in which cerebrospinal fluid (CSF) was sent for cell count were reviewed to determine which cerebrospinal-fluid tests affect diagnosis or therapy. Among 334 cases (60%) with a normal opening pressure, cell count, and protein, 1385 additional tests were done, but such tests were useful in only 3 patients (0.9%) with multiple sclerosis. Among 148 consecutive cases of bacterial, chronic infectious, and malignant meningitis the opening pressure, cell count, or protein was abnormal in all but 3 (2 childhood bacterial meningitis and 1 cryptococcal meningitis in a patient with the acquired immunodeficiency syndrome). If the opening pressure, cell count, and protein are normal, no additional CSF tests are needed in most instances; however, in immunocompromised patients and in those with possible multiple sclerosis or childhood bacterial meningitis additional tests may be indicated.
D000293:Adolescent; D000328:Adult; D002452:Cell Count; D002555:Cerebrospinal Fluid / Q000032:analysis / Q000166:cytology*; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D002675:Child, Preschool; D002908:Chronic Disease; D019411:Clinical Laboratory Techniques / Q000379:methods* / Q000706:statistics & numerical data; D003955:Diagnostic Tests, Routine; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D005947:Glucose / Q000134:cerebrospinal fluid; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D007223:Infant; D007427:Intracranial Pressure; D008581:Meningitis / Q000175:diagnosis; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies
D002556:Cerebrospinal Fluid Proteins; D005947:Glucose