CSF Gucose level & Meningitis

CSF Gucose level & Meningitis

1. By Dr KHALED ALGARIRI International Medicine School – MSU May 201 7 Glucose level in CSF

2. What is the meningitis and what are the types? Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling. However, injuries, cancer, certain drugs, and other types of infections also can cause meningitis. It is important to know the specific cause of meningitis because the treatment differs depending on the cause.

3. What is Bacterial Meningitis? Bacterial meningitis is very serious and can be deadly. Death can occur in as little as a few hours. Most people recover from meningitis. However, permanent disabilities (such as brain damage, hearing loss, and learning disabilities) can result from the infection.

4. How B. Meningitis spread? Generally, the germs that cause bacterial meningitis spread from one person to another. Certain germs, such as Listeria monocytogenes , can spread through food. How people spread the germs often depends on the type of bacteria. It is also important to know that people can carry these bacteria in or on their bodies without being sick. These people are “carriers.” Most carriers never become sick, but can still spread the bacteria to others. Here are some of the most common examples of how people spread each type of bacteria to each other: Mothers can pass group B Streptococcus and Escherichia coli to their babies during labor and birth. People spread Hib and Streptococcus pneumoniae by coughing or sneezing while in close contact with others, who breathe in the bacteria. People spread Neisseria meningitidis by sharing respiratory or throat secretions (saliva or spit). This typically occurs during close (coughing or kissing) or lengthy (living in the same household) contact. People can get Escherichia coli by eating food prepared by people who did not wash their hands well after using the toilet. People usually get sick from Escherichia coli and Listeria monocytogenes by eating contaminated food

5. Risk factors of B. Meningitis Age Babies are at increased risk for bacterial meningitis compared to people in other age groups. However, people of any age can develop bacterial meningitis. See section above for which bacteria more commonly affect which age groups. Community setting Infectious diseases tend to spread where large groups of people gather together. College campuses have reported outbreaks of meningococcal disease, caused by N. meningitidis . Certain medical conditions There are certain medical conditions, medications, and surgical procedures that put people at increased risk for meningitis. Working with meningitis-causing pathogens Microbiologists routinely exposed to meningitis-causing bacteria are at increased risk for meningitis.

6. What is Viral Meningitis? How it spread? Viral meningitis causesd by viruses , it is the most common type of meningitis, an inflammation of the tissue that covers the brain and spinal cord. It is often less severe than bacterial meningitis, and most people get better on their own (without treatment). However, it’s very important for anyone with symptoms of meningitis to see a healthcare provider right away because some types of meningitis can be very serious, and only a doctor can determine if you have the disease, the type of meningitis, and the best treatment, which can sometimes be lifesaving. If you have close contact with a person who has viral meningitis, you may become infected with the virus that made that person sick. However, you are not likely to develop meningitis. That’s because only a small number of people who get infected with the viruses that cause meningitis will actually develop viral meningitis.

7. Risk Factors of V. Meningitis children younger than 5 years old, and people with weakened immune systems caused by diseases, medications (such as chemotherapy), and recent organ or bone marrow transplantations. Babies younger than 1 month old and people with weakened immune systems are more likely to have severe illness.

8. What is Fungal Meningitis ? How it spread? Fungal meningitis is rare and usually caused by fungus spreading through blood to the spinal cord. Although anyone can get fungal meningitis, people with weakened immune systems, like those with an HIV infection or cancer, are at increased risk. The most common cause of fungal meningitis for people with weak immune systems is Cryptococcus . This disease is one of the most common causes of adult meningitis in Africa. Fungal meningitis is not spread from person to person. Fungal meningitis can develop after a fungus spreads through the bloodstream from somewhere else in the body to the brain or spinal cord or from an infection next to the brain or spinal cord.

9. Risk factors of F. Meningitis Certain diseases (such as diabetes , cancer and HIV), medications, and surgical procedures may weaken the immune system and increase your risk of getting fungal infection, which can lead to fungal meningitis. Premature babies with very low birth weights are also at increased risk for getting Candida blood stream infection, which may spread to the brain .

10. CSF glucose test A CSF glucose test measures the amount of sugar (glucose) in the cerebrospinal fluid (CSF). CSF is a clear fluid that flows in the space surrounding the spinal cord and brain.

11. How the Test is Performed LUMBAR PUNCTURE A lumbar puncture is a medical procedure where a needle is inserted into the lower part of the spine to test for conditions affecting the brain, spinal cord or other parts of the nervous system

12. CSF is collected by lumbar puncture between third, fourth, fifth lumbar vertebrae. It requires certain precautions and careful technique to prevent the introduction of infection or the damaging of neural tissue. Lumbar puncture

13. Risk Factors

14. CSF is collected in three sterile tubes Tube 1 – used for chemical and serologic test: centrifuge and use supernatant for chemistry analysis (glucose, protein, enzymes and chloride)\ kept in freezer till performed. Tube 2 – used for microbiology lab\ kept in room temperature Tube 3 – used for hematology (cell count) Cell counts done as soon as possible after the fluid is collected as cellular degradation occurs rapidly. If postponed, refrigerate for up to one hour .

15. Normal Values The glucose level in the CSF should be 50 - 80 mg/100 mL (or greater than 2/3 of the blood sugar level). Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results

16. What abnormal results mean? Abnormal results include increased and decreased glucose levels. Abnormal results may be due to: Infection (bacterial or fungus) Inflammation of the central nervous system Tumors

17. CSF/blood glucose ratio Normal CSF glucose / plasma glucose ratio is approximately 0.6-0.7 (N.B. Ratio is decreased if plasma glucose is more than 500 mg/dl due to saturation of the glucose carrier system to CSF CSF/blood glucose ratio may be a better single indicator for bacterial meningitis. Since the CSF glucose and blood glucose values are promptly and easily obtained from a lumbar puncture

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