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What tubes are taken in lumbar puncture?
tube 1: cell count, cytospin
tube 2: glucose, protein
tube 3: culture, acid fast bacilli
tube 4: cryptococcus antigen, bacterial antigen
tube 5: virology studies
What are the normal values in a lumbar puncture panel?
- Appearance: Clear- Opening pressure: 10-20 cm H20- WBC count: 0-5 cells/µL (< 2 polymorphonucleocytes - Glucose level: >60% of serum glucose ; >40mg/dl- Protein level: < 45 mg/dL
when to suspect bacterial infection?
- Appearance: Clear, cloudy, or purulent- Opening pressure: Elevated (>25 cm H 2 O)- WBC count: >100 cells/µL (>90% PMN); partially treated cases may have as low as 1 WBC/µLGlucose level: - Low (< 40% of serum glucose)- Protein level: Elevated (100-500 mg/dl)
When to suspect viral infection?
Appearance: Clear
Opening pressure: Normal or elevated
WBC count: 10-1000 cells/µL (lymph but PMN early)
Glucose level: >60% serum glucose (may be low in HSV infection)
Protein level: Elevated (50-100 mg/dL)
When to suspect fungal infection?
- Appearance: Clear or cloudy
- Opening pressure: Elevated
- WBC count: 10-500 cells/µL
- Glucose level: Low
- Protein level: Elevated
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