Question of the week (2)!

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Hani
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Question of the week (2)!

Unread post by Hani »

A 43-year-old Asian man presents with headache and neck stiffness. CT brain is normal and a lumbar puncture is performed with the following results

Serum glucose: 4.7 mmol/l

Lumbar puncture reveals:
  • Opening pressure: 15 cmCSF
  • Appearance: Cloudy
  • Glucose: 3.3 mmol/l
  • Protein: 0.7 g/l
  • White cells: 100 / mm3 (70% lymphocytes)
What is the most likely diagnosis?
  • A. Bacterial meningitis.
    B. Viral meningitis.
    C. Tuberculous meningitis.
    D. Normal CSF result.
    E. Cryptococcal meningitis.
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Re: Question of the week (2)!

Unread post by SudaMediCa »

B. Viral Meningitis

The CSF lymphocytosis combined with a glucose greater than half the serum level points towards a viral meningitis. TB meningitis is associated with a low CSF glucose

Meningitis: CSF analysis

Bacterial
Appearance Cloudy
Glucose Low (< 1/2 plasma)
Protein High (> 1 g/l)
White cells 10 - 5,000 polymorphs/mm³

Viral
Appearance Clear/cloudy
Glucose Normal*
Protein Normal/raised
White cells 15 - 1,000 lymphocytes/mm³

Tuberculous
Appearance Fibrin web
Glucose Low (< 1/2 plasma)
Protein High (> 1 g/l)
White cells 10 - 1,000 lymphocytes/mm³


*mumps is unusual in being associated with a low glucose level in a proportion of cases. A low glucose may also be seen in herpes encephalitis
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Re: Question of the week (2)!

Unread post by salmak.z. »

hello all members. i`m new here so excuse me for any mistakes.
i` wana know where can i send new q?? as a replay or how is it done
thax.
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Re: Question of the week (2)!

Unread post by nahid yusuf »

E. Cryptococcal meningitis.
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Re: Question of the week (2)!

Unread post by Hani »

The answer is: Viral Meningitis
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Re: Question of the week (2)!

Unread post by heyam »

viral mengitis
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Re: Question of the week (2)!

Unread post by SudaMediCa »

salmak.z. wrote:hello all members. i`m new here so excuse me for any mistakes.
i` wana know where can i send new q?? as a replay or how is it done
thax.

Please check this to know how:
viewtopic.php?f=79&t=1663
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