Interpretation Of Lumbar Puncture

Front 1

What tubes are taken in lumbar puncture?

Back 1

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

Front 2

What are the normal values in a lumbar puncture panel?

Back 2

- 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

Front 3

when to suspect bacterial infection?

Back 3

- 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)

Front 4

When to suspect viral infection?

Back 4

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)

Front 5

When to suspect fungal infection?

Back 5

- Appearance: Clear or cloudy

- Opening pressure: Elevated

- WBC count: 10-500 cells/µL

- Glucose level: Low

- Protein level: Elevated